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Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Iressa as First Line Therapy in NSCLC,Iressa as First Line Therapy i,Personal details,Personal details,Mrs.Chen-Lin,Female,62 y/o,Non-smoker,Personal detailsPersonal detai,Patient history,History,Cough,left chest pain for two months,Bronchoscopic biopsy and effusion cytology:adenocarcinoma.,Performance status,ECOG PS,3,Previous treatment,Refused any chemotherapy,Patient historyHistory,Investigations,Image,CT scan of chest revealed evidence a huge mass,measured,greater than,5.,0,cm in diameter to left uppe lobe with pleural effusion.Enlarged LNs to AP window.No evidence of distal mets.T4N2M0,stage IIIB,InvestigationsImage,Treatment,Refused any chemotherapy again and again,Iressa 250 mg,per day,TreatmentRefused any chemother,Outcome,Tumor size is getting smaller after,two weeks,Iressa treatment.,Follow up image study:PR,Patient can walk well now.,Iressa is ongoing till now.,No severe side effect except skin eruption but patient can tolerate it.,OutcomeTumor size is getting s,IRESSA 250 mg,Two weeks later,IRESSA 250 mgTwo weeks later,Ten weeks later,Iressa 250/day,Ongoing,Ten weeks laterIressa 250/day,Comments/Conclusion,Iressa as first line therapy is effective.,Poor performance scale:Iressa will improve it if effective.,Female,Adenocarcinoma,Non-smoker,Oriental,Comments/ConclusionIressa as,Discussion and learning points,Iressa in first line therapy of NSCLC patients?,Less side effect.,Well quality of life.,Discussion and learning points,7256,Phase II trial of first-line gefitinib in patients unsuitable for chemotherapy with stage III/IV non-small-cell lung cancer,D.Swinson.UK,Gefitinib 250 mg per day,M/F 29/16,unfit/declined CT 25/20,Median age:76,PS 0/1/2/3:1/15/27/1,41 evaluable,PR 9.8%,SD 36.6%,PD 53.4%,Median over survival 82 days,Disease control rate 46.4%at one month,7256 Phase II trial of first,Iressa as Third Line Therapy(a patient with bone and brain mets after Gemzar plus cisplatin and Taxotere),Iressa as Third Line Therapy,Personal details,Personal details,Mr.Chen,Male,43 Y/O,Cigarette smoking:40 pack-years,Personal detailsPersonal detai,Patient history,History,Cough,hemoptysis,Dx after image and bronchoscopic studies,Bronchogenic carcinoma,LLL,adeno-type,Patient historyHistory,Investigations,CT scan,Tumor size 5.3 cm,LNs mets,bilateral,Pleural effusion,left,Bone scan,Multiple bone mets,ISS Staging,T4N3M1,bone mets,stage IV,Performance status,ECOG,PS 0,InvestigationsCT scan,Treatment,Gemzar 1000mg/M2 plus Cisplatin 75mg/m 2,PD after three cycles treatment,Taxotere 25-30 mg/m2,weekly schedule,SD of Chest image studies,Unstable gait with refractory nausea,hiccup after 4 cycles taxotere treatment,Multiple brain mets diagnosed with CT scan,Iressa 250 mg per day after a course of whole brain irradiation.,TreatmentGemzar 1000mg/M2 plus,Gemzar plus cisplatin,Progressive disease,3,cycles,11/,JUN/2002,Taxotere,Gemzar plus cisplatinProgressi,13/,NOV/2003,Iressa 250 mg per day,Brain mets,Radiotherapy,13/NOV/2003Iressa 250 mg per d,17/,DEC/2003,right now,Gefinitib,17/DEC/2003right nowGefinitib,Outcome,Tumor size in lung and,pericardial,pleural effusion,volume,reduced after one month Gefitinib treatment,Brain mets,under well control,CNS condition is stable and he can walk and do some easy thing,ECOG PS around 0-1 now,Iressa 250 mg per day is ongoing,OutcomeTumor size in lung and,Comments/Conclusion,Iressa is effective even in life-threatening condition of far-advanced lung cancer,Brain mets is still effective?,Comments/ConclusionIressa is,Discussion and learning points,Iressa and brain blood barrier?,Iressa as third line therapy is standard after taxane and cisplatin failure,Discussion and learning points,Irregular treatment of Iressa in a patient of NSCLC,Irregular treatment of Iressa,Personal details,Personal details,Mr.Chen,Male,42 y/o,Cigarette smoking,20 pack-years,Personal detailsPersonal detai,Patient history,History,Referred from other hospital because of bronchogenic carcinoma,RLL,T4N2M1distal spinal mets with paraplegia.,Performance status,ECOG PS 3-4,Previous treatment,C/T with Gemzar plus cisplatin,Patient historyHistory,Investigations,CT scan of chest,Tumor mass,measured 85 mm to RLL with RLL collapse,Pleural effusion to right side,Mediastinal LNs mets,Bone scan,Multiple increased uptake to Lumbar and thoracic spine,InvestigationsCT scan of chest,Treatment,Taxotere was given after admission,Steroid and Radiotherapy for spinal mets,PD after three cycles weekly schedule therapy with taxotere 25-30 mg/M2,Iressa 250 mg QD,one month later,Pleural effusion disappeared,Tumor size reduced to 3.5 cm,TreatmentTaxotere was given af,PD after Gemzar plus cisplatin as first line,And Taxotere as second line,Iressa 250 mg/day six months later,PD after Gemzar plus cisplatin,Outcome,Pati
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