即将4年,EGFR19+TP53+CDK4扩增+EGFR扩增,盲试卡马有效
本帖最后由 回归 于 2024-7-31 15:09 编辑母亲20年9月底确诊肺腺癌IV期,EGFR19突变,阿美31个月耐药—>化疗—>SBRT—>化疗
目前进展,基因检测EGFR19+TP53+CDK4扩增+EGFR扩增,医生认为无明确靶向方案,考虑换化疗方案紫杉醇,因这个会掉头发,母亲感觉有些抗拒;
7月准备原方案(培美*4+卡铂*4+贝伐*4)再一个周期,自己尝试阿法替尼试试,目前已吃5天,体感无变化;
请教:
1)若阿法替尼无效,请教下一步路还能怎么走?试达克?西妥昔单抗?舒沃替尼?
2)基因检测组织肿瘤细胞占比仅3%,是不是也可以盲试下met突变,卡马?卡博?
3)抗血管药贝伐用了一年多了,要不要尝试换其他抗血管?安罗?凡德他尼?卡博?尼达尼布(每次CT都有写散在纤维灶)?
4)化疗除了紫杉醇,有其他副作用更小的化疗方案么?吉西他滨是不是副作用小点?
5)尝试CDK4基因的药物,哌柏西利?阿贝西利?
6)我们有个BRCA2丰度挺高的,要不要尝试奥拉帕利?
7.31日更新:阿法替尼一周后,原方案化疗(培美*4+卡铂*4+贝伐*4)无效,化疗后第三天疼痛加重,吃阿美+阿法一周体感无改善,盲试阿美+卡马有效,次日体感变好,现在不用手按已经不痛了;
既往治疗记录
时间 治疗方案 补充说明副作用及体感
20.10-21.3月 单药阿美替尼6个月淋巴结转移消失,原发病灶第一个月缩小后稳定
左肺上叶3.0×2.2左右,缩小后1.8cm×1.4cm
偶尔口腔溃疡,体感好
21.4-21.5月 阿美替尼2个月+贝伐2次 因心包积液,医生建议联合贝伐,2次贝伐后因突然月经(停经)停用 声音嘶哑,体感好
21.6-23.4月 单药阿美替尼23个月
(累计31个月) 2-4月复查局部缓慢进展,增大到3*3左右;气管镜未取到组织,做血液基因检测(停药5天),无有效突变;data:image/png;base64,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 偶尔口腔溃疡,体感好;3月下旬开始左胸偶尔疼痛,牵扯左肩背疼痛
23.5-7月 化疗4次,培美*4+卡铂*4+贝伐*4,期间阿美化疗后停用10天,相当于吃11停10 化疗效果挺好,CT未报尺寸,我自己看着感觉小了有一半,考虑放疗,医生建议再化疗2个周期把病灶打到最小
6月复查脑核磁,有新增一个异常,右侧板障强化灶,不确定是否为转移;胃口不佳,化疗后一周左右乏力1-2天,骨髓抑制(白细胞粒细胞低),打过2次升白针;左胸疼痛频率减少
23.8-9月 化疗3次,培美*4+贝伐*4,阿美吃11停10
CT稳定未继续缩小,准备放疗声音嘶哑,骨髓抑制(粒细胞最低1),体感尚可;深呼吸左胸略微疼痛
23.10月 10.16-10.20SBRT放疗5次,单次剂量800cGy CT无明显变化; 深呼吸左胸略微疼痛
23.11-24.2月 化疗5次,培美*4+贝伐*4,阿美吃11停10 放射性肺炎,未做治疗声音嘶哑,骨髓抑制,体感尚可;深呼吸左胸略微疼痛
2024.3月 化疗1次,培美*4,阿美吃11停10 左肩疼痛考虑手术,停用贝伐 深呼吸左胸略微疼痛
2024.4月 单药阿美替尼因清明回了趟老家,累+着凉,发烧严重(高烧3天,低烧2天),手术取消; 咳嗽,失声
24.5-24.6月 化疗2次,培美*4+卡铂*4+贝伐*4,阿美吃11停10 5月CT复查进展,一下增大到34mmx32mm
PETCT胸膜转移,累犯心包不除外,多发结节,左肺下叶明显,肝胃间隙淋巴结转移;
先化疗了一个周期;6月穿刺基因检测,组织肿瘤细胞占比仅3%
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
侧睡疼痛,不清楚是骨头还是什么,疼痛已经影响睡眠;
化疗后体感有变好,疼痛有缓解,已不影响睡眠,但还是会疼;这两次化疗没怎么乏力,胃口不佳,第三周骨髓抑制(粒细胞1.2);
24.7月7.4-7.12 阿法替尼,无效
7.12化疗,培美*4+卡铂*4+贝伐*4,无效
7.16-7.22,阿美+阿法,无效
7.23至今,阿美+卡马,体感变好 7月CT未缩小,有新增小结节,勉强算稳定,不确定算不算缓慢进展;
复查脑核磁,较前相仿;
化疗后第三天疼痛加重,吃阿美+阿法一周体感无改善,盲试阿美+卡马有效,次日体感变好,现在不用手按已经不痛了
确诊时PET以及5月进展的局部PET结果:
5.14日增强CT和7.5日最新CT:
6月基因检测结果:
@keenman @申医生 @阳光~ 麻烦帮忙看看,多谢多谢~ 顶一下 加油 有没有确诊时的pet-ct报告,还有本次基因检测报告,以便大家全面了解 我编辑补充PET截图和基因检测截图,保存不了报这个错是什么原因? 永尾完冶 发表于 2024-7-10 09:30
有没有确诊时的pet-ct报告,还有本次基因检测报告,以便大家全面了解
感谢提醒,已补充~ 1,单药阿法控制力不太行,换达克一样道理,舒沃有效率更不高,考虑价格,下策,再考虑西妥昔的原因是什么,我不太明白。
2,没有准确的基因检测指导,卡博和卡马可以考虑赌一把。
3,可以试试联合安罗,比如阿法加安罗或者阿法加卡博。但是需要警惕,进展期也是脑转告发期,脑核磁别漏掉了。
4,大多数二线化疗药都是紫杉醇类,有效率也可以,吉西他滨或者长春瑞滨这些也有病友尝试有效的,副作用因人而异。
5-6,这两个靶点用药就属于跨癌种用药了,病友反馈数据不太多,没有办法的时候,再考虑吧,暂时你家还有很多方案可以考虑呢。 就你的问题回复如下:
1)若阿法替尼无效,请教下一步路还能怎么走?试达克?西妥昔单抗?舒沃替尼?
回复:如果阿法替尼无效的话,从草根的角度考虑,也可以尝试用阿法替尼联合卡马替尼,看看有没有MET靶点当时没有测出来
2)基因检测组织肿瘤细胞占比仅3%,是不是也可以盲试下met突变,卡马?卡博?
回复:见问题1的回复
3)抗血管药贝伐用了一年多了,要不要尝试换其他抗血管?安罗?凡德他尼?卡博?尼达尼布(每次CT都有写散在纤维灶)?
回复:如果联合卡马替尼无效,说明没有c-MET扩增,采用原有的EGFR靶向药联合一个抗血管生成类靶向药也是可以尝试的,我个人更倾向于仑伐替尼,另外安罗替尼的药物可及性会更强一些;
4)化疗除了紫杉醇,有其他副作用更小的化疗方案么?吉西他滨是不是副作用小点?
回复:白紫的副作用除了脱发外,其他的副作用其实不大,在培美耐药后,白紫的有效率要比吉西他滨高一些;
5)尝试CDK4基因的药物,哌柏西利?阿贝西利?
回复:个人感觉肺癌患者,用CDK4的靶向药基本没啥效果;
6)我们有个BRCA2丰度挺高的,要不要尝试奥拉帕利?
回复:这个BRAC2显示的是个无临床意义的突变,我觉得没必要去试。
后续如果靶向药效果都不好,还是要趁着身体状况好,免疫系统健全的时候,考虑化疗联合免疫的治疗方案 阳光~ 发表于 2024-7-10 14:18
1,单药阿法控制力不太行,换达克一样道理,舒沃有效率更不高,考虑价格,下策,再考虑西妥昔的原因是什么 ...
感谢阳光~,考虑西妥昔是因为基因报告里有这个药,还有就是之前看的一个医生其实不建议我们用阿法,她当时提了一句用阿法还不如试西妥昔;