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Posted by Ernestine on 28.11.2016 18:40:17: tarceva for metastatic lung cancer - от : stree

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Yang X. Tan AR, Nguyen D, Lipkowitz S & Swain SM 2004 Gene expression profile changes following erlotinib treatment in patients with metastatic breast cancer. Journal of Clinical Oncology 22 (14S) 577.
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Example 10: Preparation of erlotinib hydrochloride from 6,7-bis(2-methoxyethoxy)-4-methoxyauinazoline using sec -BuLi and 3-ethynylaniline hydrochloride
Withhold Tarceva in patients developing severe renal impairment until renal toxicity is resolved. Perform periodic monitoring of renal function and serum electrolytes during Tarceva treatment.
Roche agreed to lower the price of the lung cancer drug Tarceva to make it available in the U.K. It’s the latest example of regulators there taking a skeptical view of expensive new cancer drugs.
Other information about Tarceva
Background This phase II, open-label study evaluated the efficacy and safety of erlotinib as second-line therapy in non-small-cell lung cancer (NSCLC) patients with brain metastases (BM).
Common Questions and Answers about Can you cut tarceva in half
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Increase in soluble PD-1 is associated with prolonged survival in patients with advanced EGFR -mutated non-small cell lung cancer treated with erlotinib
Activating EGFR mutations, including exon 19 deletions and the L858R point mutation, predict response to erlotinib or gefitinib therapy. T790M and exon 20 insertion mutations predict resistance (Table ). KRAS mutations predict non-response to EGFR and ALK inhibitors, and thus alternative therapies should be considered. 1 Detection of ALK rearrangements in patients with advanced NSCLC suggests eligibility for treatment with the ALK inhibitor crizotinib 10 but not with EGFR-directed inhibitors.
"My father was diagnosed with Non-Small Cell Lung Cancer with EGFR mutation May 2014 and has done very good. He is turning 72 in February. He is on Tarceva and it shrunk his two lung tumors down and now he is in remission. He got the tube removed. Now he has a cold and a sore throat and I am very worried he is going to get sick. I try really hard to pursue him to take immune pills and take care of himself but hey I can't have him be a germaphobic like me."
The term acquired resistance (also known as secondary resistance) is used to describe patients who: (1) have been treated with a single-agent EGFR-TKI (e.g. gefitinib or erlotinib), (2) have either or both a tumor with an EGFR mutation associated with drug sensitivity or objective clinical benefit from treatment with an EGFR TKI, (3) suffer from systemic progression of disease (according to the Response Evaluation Criteria in Solid Tumors or World Health Organization) while on continuous treatment with gefitinib or erlotinib within the last 30 days, and (4) have not treated with intervening systemic therapy between the cessation of gefitinib or erlotinib and initiation of new therapy [ 19 ]. In other words, secondary resistance affects patients who have initially responded to treatment, but subsequently stopped responding [ 10 ]. Some of the molecular mechanisms of acquired resistance include T790M second mutation, mesenchymal epithelial transition factor (MET) amplification, ATP-binding cassette (ABC)-G2 transporter (ABCG2) and hepatocyte growth factor (HGF) overexpression, insulin-like growth factor (IGF) binding protein-3 (IGFBP3) downregulation, as well as ERBB3 activation.
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24. Zhou JG, Tian X, Wang X, Tian JH, Wang Y, Wang F, et al. Treatment on advanced NSCLC: platinum-based chemotherapy plus erlotinib or platinum-based chemotherapy alone? A systematic review and meta-analysis of randomised controlled trials. Med Oncol. 2015;32: 471. doi: 10.1007/s12032-014-0471-0. pmid:25579169
Recent studies have evaluated EGFR expression in tumors by immunohistochemistry (IHC), fluorescence in situ hybridization (FISH), and mutational analysis. Sensitizing mutations of EGFR are the most reliable predictor of response to erlotinib or gefitinib (11. 28 ).
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15nM). Similar to HCC827 cells, we found (1) overexpression of AXL in the absence of EGFR T790M, pEGFR and increased pMET, (2) overexpression of the EMT marker vimentin, and (3) that inhibition of AXL by siRNA, MP-470 or XL880 restored sensitivity to concurrent erlotinib treatment in the H3255 ER sublines (Supplementary Figure 10 ). Together, these data show that AXL upregulation promotes erlotinib acquired resistance in the setting of EMT in EGFR -mutant NSCLC tumor models and that combined inhibition of AXL and EGFR overcomes acquired resistance to erlotinib in these models.
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Erlotinib bei Lungenkrebs und Pankreaskarzinom
Erlotinib has recently been shown to be a potent inhibitor of JAK2V617F activity. JAK2V617F is a mutant of tyrosine kinase JAK2. is found in most patients with polycythemia vera (PV) and a substantial proportion of patients with idiopathic myelofibrosis or essential thrombocythemia. The study suggests that erlotinib may be used for treatment of JAK2V617F-positive PV and other myeloproliferative disorders. [7]
Therapeutics belonging to the group of epidermal growth factor inhibitors are currently in widespread use for the treatment of certain malignancies, especially in advanced non-small cell lung cancer. A wide spectrum of the cutaneous side effects of these drugs are well known but the ocular side effects and trichomegaly of eyelashes are rarely reported, particularly for an ophthalmology audience. This report presents a case of erlotinib induced eyelash trichomegaly and the other ocular side effects of this drug in a 74 year-old female patient with metastatic lung adenocarcinoma. Trichomegaly is not a drug-limiting side effect, however long eyelashes often cause eyeball irritation and corneal epithelial defects. Herein, the authors emphasize the importance of recognizing this side effect in order to avoid from severe complications such as corneal ulcers in uncared patients.
Taken together, the available trial data suggest that EGFR tyrosine kinase inhibitors have efficacy that is similar to that of standard chemotherapy as second- or third-line treatment for patients with advanced NSCLC. Among patients receiving first-line therapy, tyrosine kinase inhibitors appear to be inferior to standard chemotherapy overall but superior for selected patients, especially for those with activating EGFR mutations. Although some differences in the trial results for erlotinib and gefitinib have led to differences in regulatory policy, no head-to-head comparison of the two agents has been conducted. Therefore, no definitive conclusions can be drawn regarding substantive differences in the efficacy of these two agents.
03 de Abril del 2016 a las 09:17 pm Principio Activo (P.A) Erlotinib
The EGFR inhibitors overall are quite well-tolerated, but they do have some characteristic side effects. Overall, EGFR inhibitors, the current batch of first- and second-generation inhibitors, like gefitinib, erlotinib, and afatinib, all have rash and diarrhea as side effects due to inhibition of wild-type EGFR. I would say we see the most side effects with afatinib, compared to erlotinib and gefitinib.
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Time- and concentration-dependent inactivation of CYP3A by erlotinib. (A) At the indicated time points, the remaining CYP3A activity was measured by a midazolam 1′-hydroxylation (A1), testosterone 6β-hydroxylation (A2) or nifedipine oxidation (A3) assay. Each point represents the mean of triplicate incubations. The observed inactivation rate constants, k obs . were calculated from the slopes of the regression lines in A. (B) The hyperbolic plot of k obs versus erlotinib concentration was used to calculate kinetic constants.
. Erlotinib or gefitinib for the treatment of relapsed platinum pretreated non-small cell lung cancer and ovarian cancer: A systematic review. Drug Resist Updat 2011 ; 14. 177 - 190.
For additional information regarding Tarceva or non-small cell lung cancer, please contact the Tarceva Web Site
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What conditions does Tarceva treat?

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