【Fexofenadine】評論

REF: 2015 財團法人醫藥品查驗中心當代醫藥法規月刊EGFR-TKI標靶治療藥品用於晚期及轉移性非小細胞肺癌——療效直接比較之文獻回顧

【Filgrastim zz】評論

(A) dabrafenib (Tafinlar®): BRAF Kinase Inhibitor用於治療BRAF V600 突變陽性之黑色素瘤、非小細胞肺癌

【terminator812】評論

EGFR mutation-positive — Treatment with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors ([TKIs] osimertinib, erlotinib, gefitinib, afatinib) as single agents is indicated for the initial management of patients whose tumors contain an activating mutation in EGFR. This is preferred over chemotherapy- and immunotherapy-based approaches for patients with an identified driver mutation.In this setting, first-line treatment with an EGFR TKI improves outcomes compared with standard platinum-based chemotherapy. The impact on OS is less evident since EGFR TKIs were frequently used as second-line therapy after chemotherapy in the clinical trials demonstrating the efficacy of this approach. Among the EGFR TKIs, osimertinib has demonstrated improvements in PFS over erlotinib and gefitinib and is our preferred frontline agent [4]. (See "Systemic therapy for advanced non-small cell lung cancer with an activating mutation in the epidermal growth factor receptor", section on 'Efficacy of single-agent EGFR TKIs'.)Overview of the initial treatment of advanced non-small cell lung cancer - UpToDate 

【666】評論

統整 Advanced non-small cell lung cancer 初始治療無特定基因變異或未知基因變異 初始治療1. PD-L1 表現 50%以上: pembrolizumab 或 atezolizumab2. PD-L1 表現 50%以下:    - nonsquamous : pembrolizumab + pemetrexed, carboplatin 或 cisplatin     其他:  bevacizumab + platinum-based (+atezolizumab) - 無EGFR和ALK變異   - squamous :  pembrolizumab + carboplatin + paclitaxel 或 nab-paclitaxel3. 以上是常用療法，除此之外FDA也核准用nivolumab + ipilimumab 於 PD-L1 表現 1 % 以上的患者維持治療4-6 cycle 的 pembrolizumab + pemetrexed若初始用bevacizumab，繼續用bevacizumab有已知基因變異1. EGFR變異    EGFR tyrosine kinase inhibitors [TKIs]: osimertinib, erlotinib, gefitinib, afatinib 單一藥物治療    補充: 初始治療通常不併用 platinum-based 化療 (因為毒性增加)2. ALK變異    ALK TKI:     首選 - Alectinib     次 - Ceritinib轉移1. 腦, 腎上腺: 手術 或 definitive radiation therapy (RT)2. 骨頭: 手術 或 RT + denosumab 或 zoledronic acid (抑制骨蝕)