部分中文Vandetanib处方信息（仅供参考）
提示：本品凡德他尼粉末供研究使用，不用于疾病治疗
凡德他尼粉末/Vandetanib
藥商/藥價
 (阿斯特捷利康)
商品英文名稱
Zactima (ZD6474)
商品中文名稱
劑型
300 mg/day
藥理作用
1. 作用係藉由抑制血管內皮生長因子 (VEGF)，表皮生長因子(EGF)，轉染時重組 (RET) 細胞酪胺酸激酶活性
2. 常用劑量
衛生署許可證適應症
健保藥品給付規定
副作用
腹瀉(等級 3/4) 有8.4%、疹(等級 3/4) 有4.8%，和無症狀QTc延長 (都是等級1)有 20.5%。
參考文獻
備註
1. 正在進行用於NSCLC的第3期試驗
 2. FDA批准ZD6474(Zactima，阿斯利康生產)為治療濾泡性、髓樣、未分化甲狀腺癌，以及局部進展期和轉移性乳狀頭狀甲腺癌的罕見藥(Orphan drug)。
Vandetanib (vandetanib) is a synthetic aniline quinazoline compound, known as "second generation easy to Ruisha", for the oral small molecule multi-target nitric acid kinase inhibitor (TKI), can simultaneously act on tumor cell EGFR , VEGFR and RET tyrosine kinases, and optionally to inhibit other tyrosine kinases, as well as serine / threonine kinases.
Phase I clinical studies have shown that dose-limiting toxicity is diarrhea, hypertension and rash. Common side effects are diarrhea, rash, nausea, vomiting, and asymptomatic QT prolongation. The toxic and side effects were dose-related. At <300 mg / d, the patient was well tolerated and the maximum tolerated dose (MTD) was 300 mg. Phase II clinical studies involving many diseases.
At present, our country is conducting clinical trials of vancomycin in the treatment of NSCLC.
1. Treatment of advanced NSCLC (non-small cell lung cancer) 003 study compared the efficacy of vancomycin 300 mg / d and gefitinib 250 mg / d on first-line or second-line chemotherapy failure in 168 patients with advanced NSCLC efficacy, Fentanib compared with vancomacil significantly increased the efficiency and prolonged progression of disease without progression, respectively, 8% and 1%, 11.9 weeks and 8.1 weeks, respectively (P = 0.011). In clinical trials if the patient progress or can not tolerate toxicity, allowing it to change the treatment program. The test results showed that the control rate of patients treated with gefitinib instead of vandetan was 14%, while the control rate of patients treated with vancomycin instead of gefitinib reached 32%, and the median overall survival was expected to be Vanderbiltan → gefitinib for 6.1 months, and by gefitinib → van dertney for 7.4 months. (200mg / m2) + carboplatin (AUC = 6) in the first-line treatment of stage ⅢB-IV NSCLC. The aim of this study was to eva luate the efficacy of vancomycin combined with paclitaxel (200mg / m2) + carboplatin (AUC = 6) in the treatment of stage ⅢB-IV NSCLC. Preliminary trial results show that vancomacil can also be combined with traditional chemotherapy for the treatment of NSCLC, with no significant increase in 3 to 4 degrees of adverse reactions.
2. Treatment of advanced breast cancer in 46 cases, previously received paclitaxel + anthracycline chemotherapy failure in patients with metastatic breast cancer, to accept vancomacaine (100 mg or 300mg), 44 patients can be eva luated no objective effect, 2 groups Patients with 1 case of stable disease (SD) ≥ 24 weeks, the authors believe that single-drug vancome treatment of relapse-resistant breast cancer is limited, but well tolerated.
3. Treatment of advanced multiple myeloma, 18 cases of chemotherapy or hematopoietic stem cell transplantation failure in patients with multiple myeloma, oral vancomacil (100mg) 3 ~ 29.4 weeks, globulin or urine M protein no improvement, side effects Tolerable, common side effects include nausea, vomiting, diarrhea, rash, skin itching, sensory disturbances, but no clear QT interval changes.
4. Treatment of thyroid cancer thyroid myeloid carcinoma incidence is low, with hereditary, regardless of radiation therapy, combined with chemotherapy or endocrine treatment is poor, poor prognosis. 0008 study is an ongoing, open phase II study to assess the efficacy and side effects of vandetanil in the treatment of progressive hereditary thyroid medullary carcinoma. Among the 11 eva luable patients (who received either vancomycin 300 mg / d, at least 3 months), 2 patients received PR, and 9 patients received SD.
In addition, the plasma tumor markers of calcitonin and carcinoembryonic antigens were reduced by 72% and 25%, respectively, compared with baseline values. At present, it is believed that vancomycin treatment of thyroid medullary carcinoma mainly in the tumor cell target RET tyrosine kinase, RET can promote tumor cell growth and survival, 40% of the sporadic and 100% hereditary thyroid myeloid carcinoma RET overexpression of the gene.
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