17. Pirmos eilės gydymas bevacizumabu 1.0 0.8 0.6 0.4 0.2 0 Duration of PFS (months) 0 6 12 18 24 30 Probability of PFS Avastin + CP CP PFS in E4599 1 6.2 months 1 Sandler, et al. NEJM 2006; 2 Manegold, et al. ESMO 2008 PFS Avastin 15mg/kg HR=0.66 p<0.001 PFS in AVAiL 2 Duration of PFS (months) 0 6 12 18 24 30 Placebo + CG Avastin 7.5mg/kg + CG Avastin 15mg/kg + CG 6.8 months PFS Avastin 7.5mg/kg 6.6 months PFS Avastin 15mg/kg 1.0 0.8 0.6 0.4 0.2 0 Probability of PFS HR=0.75 p=0.0003 HR=0.85 p=0.0456
18. Pirmos eilės gydymas bevacizumabu didina išgyvenamumą 0 6 12 18 24 30 36 42 Avastin + CP CP OS in E4599 1 12.3 months OS Avastin 15mg/kg 1 Sandler, et al. NEJM 2006; 2 Manegold, et al. ESMO 2008 1.0 0.8 0.6 0.4 0.2 0 Duration of OS (months) Probability of OS HR=0.79 p=0.003 0 6 12 18 24 30 36 OS in AVAiL 2 Placebo + CG Avastin 7.5mg/kg + CG Avastin 15mg/kg + CG 13.6 months OS Avastin 7.5mg/kg 13.4 months OS Avastin 15mg/kg Duration of OS (months) 1.0 0.8 0.6 0.4 0.2 0 Probability of OS HR=0.93 p=NS HR=1.03 p=NS
When a ligand binds to the extracellular domain, the HER1/EGFR activates and dimerizes with another HER family receptor. This leads to transphosphorylation, or ATP-phosphorylation, of the adjacent intracellular tyrosine kinase domains.1 After ATP-phosphorylation, the receptor recruits adaptor proteins and signal transduction enzymes from the cytoplasm, which leads to further activation of multiple downstream pathways.1 Two of the signal transduction pathways from HER1/EGFR are directly involved with cell division and apoptosis. In fact, HER1/EGFR is largely responsible for normal cellular growth. These normal cellular processes can become tumorigenic when the HER1/EGFR functions inappropriately
As a small-molecule HER1/EGFR Tyrosine Kinase Inhibitor (TKI), Tarceva inhibits cellular signaling by competing with ATP for the active site of the intracellular tyrosine kinase domain.
In a study of 88 patients, VEGF was overexpressed in 77% of all NSCLC 75% of squamous cell carcinomas 73% of adenocarcinomas 100% of large cell carcinomas
Regression of tumour vasculature Normalisation of surviving vasculature Inhibition of new and recurrent vessel growth