Which patients are suitable for targeted therapy?In breast cancer, trastuzumab has been used for the adjuvant treatment after radical operat
Which patients are suitable for targeted therapy?
In breast cancer, trastuzumab has been used for the adjuvant treatment after radical operation of gastric cancer targeted therapy started relatively late, mainly for locally advanced or metastatic gastric cancer or esophageal gastric junction adenocarcinoma patients. For patients with gastric cancer who have undergone radical surgery, there is no clinical study to confirm whether targeted therapy can reduce the recurrence of the tumor and prolong the survival time of the patients.
At the same time, also need to be detected by special methods confirmed HER-2 positive patients for trastuzumab treatment. The HER-2 detection method mainly has two kinds, one is the immunohistochemical (IHC) method, the detection results of 3+ can be applied to trastuzumab therapy; another detection method for fluorescence in situ hybridization (FISH), positive if you can use trastuzumab. The proportion of HER-2 positive patients with gastric cancer detected by one of the above two methods is about 17-19%. In the ToGA study, 85 patients with gastric cancer in China were HER-2 positive, with a positive rate of about 22.7% in.
Can not be treated with chemotherapy, only target drug treatment?
In non small cell lung cancer, some targeted drugs such as human epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI, representative drug Iressa, Tarceva etc.) can be used individually to anti tumor. For trastuzumab, is still need to be used in combination with chemotherapy drugs. After a certain number of cycles of chemotherapy to achieve the best results and the maximum tolerated dose, can be used alone to continue the treatment of trastuzumab, in order to achieve sustained inhibition of tumor growth, the purpose of maintaining efficacy. Experts called for example, for example, you open a pot of water with a big fire, if you just turn off the fire, then the water will soon cool down; but if you use a small fire to burn, so the water can always maintain a high temperature, at the same time not a little while the water boiled away. The application of targeted drugs and chemotherapy also is such, if there is effect directly after the stop, may soon will come back, and the tumor began to grow; but if you have been such treatment on the side effects of chemotherapy and will let you do not eat, physical decline, scientists are using targeted drugs "high efficiency, low toxicity characteristics, with" slow fire "- targeted therapy to make your tumor was controlled in a relatively long time.
Use of trastuzumab specific?
At present, the dose is recommended in gastric cancer: first use 8mg/kg, after each dose of 6mg/kg, once every 3 weeks, with 250ml normal saline after intravenous injection, the general infusion time in 90 minutes.
Need to remind you that this drug is supported in the 440mg/ specification, the nurse after opening the package will take this powder directly with water for injection to belt with the package inside. If your weight is lighter (less than 74kg), then a drug may not be used once, the rest of the medicine you will be carefully stored in the refrigerator 2-8 degrees Celsius, which is what we call the refrigerator. If you accidentally put it into the refrigerator freezer, the drug will be denatured, you can not use the next. In addition the remaining liquid in the refrigerator room can only be kept for 28 days in 28 days, you can put the remaining syrup with trastuzumab bought a with intravenous drip, so the cycle, but the remaining drops more than 28 days can not be used.