M.V. Lomonosov Moscow State University M.V. Lomonosov Moscow State University Faculty of Basic Medicine Faculty of Basic Medicine Supervisor: M.D. A.F.Marenich 2010,Moscow
M.V. Lomonosov Moscow State University Faculty of Basic
Medicine
Supervisor:
M.D. A.F.Marenich
2010,Moscow
2.
Lung cancer is the commonest malignancy and leading cause of
cancer deaths.
At the moment , the development of Non Small Cell Lung Cancer
(NSCLC) in 25 30% of cases is diagnosed the local-extended process
and in 40 50% distant metastasis are revealed.
The conservative methods of treatment occupy key place.
3.
The 5-year relative survival rate varies markedly depending on
the stage at diagnosis, from 49% to 16% to 2% for patients with
local, regional, and distant stage disease respectively.
According to stages
I - > 60%
II - 30 - 60%
III - 5 - 30%
IV - < 5%
If high mitotic rate and tumor necrosis associated with poor
prognosis.
4. Published Chemotherapy Regimens Schedule 1 Cisplaitn 50 mg/m
2 days 1 and 8 Vinorelbine 25 mg/m 2 days 1, 8, 15, 22 Every 28
days for 4 cycles 2 Cisplaitn 100 mg/m 2 on day 1 Vinorelbine 30
mg/m 2 days 1, 8, 15, 22 Every 28 days for 4 cycles 3 Cisplaitn
75-80 mg/m 2 on day 1 Vinorelbine 25-30 mg/m 2 days 1, 8 Every 28
days for 4 cycles 4 Cisplaitn 100 mg/m 2 on day 1 Etoposide 100
mg/m 2 day 1-3 Every 28 days for 4 cycles 5 Cisplaitn 80 mg/m 2 day
1 Vinblastine 4 mg/m 2 days 1, 8, 15, 22 Every 28 days for 4 cycles
Acceptable Cisplaitn-base Regimens 1 Cisplatin 80 mg/m 2 on day 1
Gemcitabine 1000 mg/m 2 on days 1, 8 Every 21 days 2 Cisplatin 80
mg/m 2 Docetaxel 75 mg/m 2 Every 21 days Chemotherapy Regimens for
patients with comorbidities or patients not able to tolerate
cisplatin 1 Paclitaxel 200 mg/m 2 on day 1 Carboplatin AUC 6 on day
1 Every 21 days
5.
EGFR is expressed in 40 - 80% of lung cancers.
Gefitinib (Iressa 250 mg) and erlotinib (Tarseva 150 mg) were
the first two agents to target the tyrosine kinase of the EGFR.
Both of these agents have activity in NSCLC.
On the 1 st July 2009 the European Commission granted marketing
authorisation for IRESSA for the treatment of adults with locally
advanced or metastatic NSCLC.
The National Institute for Clinical Excellence (NICE) has
approved Tarceva as an alternative treatment to the chemotherapy
drug docetaxel for people with non-small cell lung cancer.
Bevacizumab, to improve survival when combined with
chemotherapy in the first-line setting.
In currently aflibercept with the combination of other drugs is
in phase III cliinical trails.
6.
To determine the significant effects of different chemotherpy
regimes
7.
To identify which one is more effective than other chemotherapy
regimes
To determine the toxicities of the drugs
8.
Patients and method
Retrospective study
Patients
- 95 patients with nom small cell lung cancer stage III IV
(Blokhins Russian Cancer Research Center from 2007 to march 2008)
ECOG performance status