我父亲肺鳞癌的治疗贴(2014年3月1日驾鹤西去）

今天开始重新吃BIBW 2992，打算吃一周。

BIBW 2992 Plus Simvastatin
Detailed Description:
One of the main reasons of resistance to EGFR tyrosine kinase inhibitors (TKIs) is that there are alternative mechanisms for persistent activating EGFR downstream signaling, including both RAS/Erk and PI3K/Akt kinase pathways. Therefore, simultaneous inhibition of both pathways would be necessary to reduce tumor cell survival more effectively. One of the candidate combinations is concurrent use of EGFR-TKIs and statins, which are irreversible inhibitors of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase and have been used to treat hypercholesterolemia through blocking the mevalonate biosynthesis pathway. Beside the cholesterol lowering effect, statins have been shown to induce apoptosis in several tumor types. It affects the synthesis of other products of the mevalonate pathway such as isoprenoids, which are used as substrates for prenylation. Attachment of isoprenoids to RAS proteins facilitates their anchoring to the cell membrane where they carried out their roles. By interrupting the biosynthesis of mevalonate, statins inhibit activation of RAS and downstream signaling cascades, including the RAF/MEK/ERK and PI3K/AKT, which play critical roles in regulation of cell survival and proliferation. Therefore, it seems to be a promising therapeutic approach overcoming tumor resistance to EGFR-TKIs, which is associated with RAS activation.
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According to the recent clinical result of phase II trial, a randomized phase II study of gefitinib with or without simvastatin in previously treated patients with advanced NSCLC conducted by Han et al.37 gefitinib plus simvastatin combination produced higher response rates than gefitinib alone in patients with non-adenocarcinoma (5/13 [39%] v 1/13 [8%], P=0.06). This finding suggests that simvastatin may enhance sensitivity to gefitinib in non-adenocarcinoma that is relatively resistant to gefitinib. Moreover, by Mantha et al.35 demonstrated that the combination of gefitinib and lovastatin showed significant synergic cytotoxic effects in vitro in a total of 16 squamous cell carcinomas, NSCLC, and colon carcinoma cell lines. Of special interest, these cell lines did not possess the activating mutations of EGFR, which confer increased sensitivity to gefitinib. Nevertheless, combining lovastatin with gefitinib induced more significant inhibition of AKT activation than either agent alone. Additionally, lovastatin significantly enhanced the sensitivity to gefitinib treatment regardless PTEN loss in glioblastoma cell lines. These results suggest that statins can augment EGFR inhibition.
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我妈今天去挂了吴医生的号，问了一些问题，
2 `* r. [7 ~: X- v  J8 t/ [1.人工抽血与机器抽血相比，机器抽血效果更好。
2.回输血后有发热反应的效果更好。
" w2 l6 `0 i2 ?3.病人本身的免疫力不能太差。
. |) u+ ^8 X7 ^4 s. v' O4.浙江省人民医院用的是DC-CIK，分开培养，混合回输。
) X0 y" i. Q3 q: B$ Z# x0 d3 v0 B! B* k5.DC-CIK只提高了一部分T免疫细胞，对B细胞无效。
) C4 ^5 {, l; @1 k6.一个疗程的DC-CIK治疗，有效持续时间是1多个月。

老马 发表于 2012-9-27 20:18

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# J$ x4 v- l8 y- B- A/ N0 F我妈今天去挂了吴医生的号，问了一些问题，
1.人工抽血与机器抽血相比，机器抽血效果更好。
2.回输血后有 ...

! q7 F7 m& p% U+ n3.病人本身的免疫力不能太差。------也就是说如果病人体质很弱了，做了就没有效果？
5.DC-CIK只提高了一部分T免疫细胞，对B细胞无效。-----B细胞是什么啊？
6.一个疗程的DC-CIK治疗，有效持续时间是1多个月。------也就是说最好3个月要做2个疗程，对么？

老马 发表于 2012-5-2 20:45

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今晚电话过去，说是喉咙不适已经没有了，也没有发生口腔溃疡，万幸！
& A! {% O6 a- u  r2 M0 }* \! B. g3 ~* M膝关节还是有点酸痛，老爸不想吃芬必 ...

2 e9 D2 V$ b2 q2 q$ J老马，想问下特罗凯耐药以后，究竟是先去化疗好呢 还是先2992好呢？

身体允许就先去化疗。
如果化疗无效，上2992.
( j( B: v( A6 f' F2 M3 \如果化疗有效，分二种情况：
化疗前如果是快速进展，化疗后上2992.
/ N/ U0 r% H. k5 l9 R化疗前如果是缓慢进展，化疗后回特试试。

我爸也是肺鳞癌，左全肺手术切除后化疗四个疗程，化疗结束的四个月后，九月份增强CT复查，纵隔处一淋巴结由原来的1.29变为现在的1.39,我开始恐慌，癌细胞又来了，医生开了替吉奥及奥美拉唑，但我还没开始给爸爸吃，正在纠结跟茫然中，不知道接下来到底该怎么办？发现了这个论坛后，我更感觉应该来这里寻找更合适的指导和帮助，以免我再走弯路，毕竟这是人命关天，我爸才五十五岁！真的很需要高人的指点，焦急地等待中。。。。。

老马 发表于 2012-9-28 15:16

                               
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身体允许就先去化疗。
, W! v- c8 M: U; S" t# o8 D+ I2 D如果化疗无效，上2992.
" }9 J* D/ m. \/ k如果化疗有效，分二种情况：

谢谢马哥 今天花了一下午的时间把您的帖子整个学习了一遍 很多精华帖啊
$ O8 x; S3 K$ @我们在301看的 大夫制定的方案是化疗(估计也不是阿瓦斯丁一类的 就是培美，健泽，泰索帝一类)+易瑞沙 这个您说合适吗？可能会导致易瑞沙的完全耐药吧

老马 发表于 2012-8-3 04:02

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前天开始把GNC Q10改成能气郎Q10了，一天吃3粒。
昨天开始打榄香烯，浙江入医保。
6 C& \0 P7 i! \3 }9 N/ w, D( {& R下周去做生物治疗。

7 x. F/ t  d6 N4 i# @. w5 ~& O为啥要把gnc的q10给换了啊？用潘南金怎么样呢？

老马 发表于 2012-6-8 21:58

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# P8 j: `$ V/ e+ b吃40mg bibw2992+20mg辛伐他汀已经15天了。

. a- L! Q$ j& C5 ]/ ]) v请问老马，40mg bibw2992是非正版吗？