Kunena :: Тема: Posted by Winnifred on 29.11.2016 8:58:39: tarceva side effects swelling (1/2)

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Posted by Winnifred on 29.11.2016 8:58:39: tarceva side effects swelling

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ТЕМА: Posted by Winnifred on 29.11.2016 8:58:39: tarceva side effects swelling

Posted by Winnifred on 29.11.2016 8:58:39: tarceva side effects swelling 8 года 4 мес. назад #908

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Good luck with tarceva.
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My options at this point seem to be to fly to Arizona every two weeks for Avastin/Tarceva. They said they don't know whether Insurance will cover extra expenses beside drug. My other option will be to try to get into MD Anderson trial with Topotecan/Iressa. Any insight to MD Anderson will be helpful, since you have been there. Thank you for your time. I am at a loss and kind of frustrated. It seems like it has kind of been turned over to me to find out whether I qualify, etc.
forum.drujba-konserv.com/viewtopic.php?p=12530#12530
Noxa is a BH3 protein that binds exclusively to Mcl - 1. 18 Letai A. Bassik MC. Walensky LD. Sorcinelli MD. Weiler S. Korsmeyer SJ. Distinct BH3 domains either sensitize or activate mitochondrial apoptosis, serving as prototype cancer therapeutics. Cancer Cell 2002 ; 2: 183 - 92 ; PMID: 12242151 ; dx.doi.org/ 10.1016/S1535-6108(02)00127-7 [CrossRef]. [PubMed]. [Web of Science ®] Noxa cannot bind to or activate Bax/Bak directly, but facilitates apoptosis by binding to Mcl - 1 and preventing Mcl - 1 sequestration of activator BH3 proteins like Bim, Bid, and Puma. Noxa expression is increased in other Bcl - 2 dependent tumors and has been shown to saturate Mcl - 1 binding sites to promote Bim binding to Bcl - 2. 19 Morales AA. Kurtoglu M. Matulis SM. Liu J. Siefker D. Gutman DM. Kaufman JL. Lee KP. Lonial S. Boise LH. Distribution of Bim determines Mcl - 1 dependence or codependence with Bcl - xL/Bcl - 2 in Mcl - 1-expressing myeloma cells. Blood 2011 ; 118: 1329 - 39 ; PMID: 21659544 ; dx.doi.org/ 10.1182/blood-2011-01-327197 [CrossRef]. [PubMed]. [Web of Science ®] Given Noxa expression is increased in Bcl - 2 dependent SMS-SAN and decreased in Mcl - 1 dependent CHLA15-ABTR and SK-N-BE(2), we sought to determine whether Noxa expression changes following small molecule inhibition of EGFR and ERK in NLF. Following a 24-hour exposure to erlotinib, Noxa protein expression increases in NLF ( Fig. 7C ). U0126 treatment does not upregulate Noxa protein expression ( Fig. 7C ). Given the lack of an effective Noxa antibody for immunoprecipitation, the interaction and changes in Noxa binding to Mcl - 1 following EGFR inhibition could not be confirmed. We have shown that ERK inhibition alone is sufficient to induce Bim's displacement from Mcl - 1, thus EGFR-mediated inhibition of Noxa via non-ERK related pathways may play a less significant role in promoting Mcl - 1 dependence in HR NBs.
Raymond E, Faivre S, Armand JP: Epidermal growth factor receptor tyrosine kinase as a target for anticancer therapy. Drugs. 2000;60 Suppl 1:15-23; discussion 41-2. PubmedLi Z, Xu M, Xing S, Ho WT, Ishii T, Li Q, Fu X, Zhao ZJ: Erlotinib effectively inhibits JAK2V617F activity and polycythemia vera cell growth. J Biol Chem. 2007 Feb 9;282(6):3428-32. Epub 2006 Dec 18. PubmedDudek AZ, Kmak KL, Koopmeiners J, Keshtgarpour M: Skin rash and bronchoalveolar histology correlates with clinical benefit in patients treated with gefitinib as a therapy for previously treated advanced or metastatic non-small cell lung cancer. Lung Cancer. 2006 Jan;51(1):89-96. Epub 2005 Nov 14. PubmedJones HE, Goddard L, Gee JM, Hiscox S, Rubini M, Barrow D, Knowlden JM, Williams S, Wakeling AE, Nicholson RI: Insulin-like growth factor-I receptor signalling and acquired resistance to gefitinib (ZD1839; Iressa) in human breast and prostate cancer cells. Endocr Relat Cancer. 2004 Dec;11(4):793-814. PubmedBlum G, Gazit A, Levitzki A: Substrate competitive inhibitors of IGF-1 receptor kinase. Biochemistry. 2000 Dec 26;39(51):15705-12. Pubmed
Tarceva (erlotinib): "My diagnosed NCLC 11/14. As of her last scans no tumors or active cancer."
Patients were treated with oral erlotinib in daily doses of 150 mg. The regimen was initiated 1 week before cisplatin-based CRT to achieve stable blood levels and continued until the last day of brachytherapy. Erlotinib was supplied by Roche Pharmaceuticals (Basel, Switzerland).
Cell Cycle Modulation and Induction of Apoptosis. DNA flow cytometry studies were performed to evaluate the effect of erlotinib, pemetrexed, and their combination on the cell cycle distribution and to determine whether their cell cycle-modulating activity might provide clues to optimize drug scheduling. Both agents were able to affect the cell cycle of NSCLC cells (Table 2 ). Erlotinib caused a 1.2- to 1.4-fold increase in the population of cells in the G 1 phase. In contrast, a 72-h treatment with pemetrexed resulted in a 1.3- to 2.0-fold increase in the percentage of cells in the S phase. The increment in the S phase cell population was most pronounced in A549 and H1650 cells (1.7- and 2-fold, respectively), whereas H292 cells showed only a 1.3-fold enhancement. A marked increase in the S phase population with respect to controls was also observed for the simultaneous combination in all NSCLC cells. In the 24-h pemetrexed + erlotinib followed by 48-h erlotinib schedule, however, the increase in the S phase population was lower, whereas more cells accumulated in the G 2 /M phase.
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A Study of Management of Tarceva - Induced Rash in Patients With Non-Small Cell Lung Cancer.
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Schedule-dependent cytotoxic synergism of pemetrexed and erlotinib in BXPC-3 and PANC-1 human pancreatic cancer cells. Wang et al . Exp Ther Med. 2011 Sep;2(5):969-975. PMID: 22977607 .
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At this point, erlotinib, pemetrexed, and docetaxel are the only medications approved as second-line options for patients with advanced NSCLC. Additionally, in March 2015, the FDA approved the anti–PD-1 agent nivolumab as a treatment for patients with advanced squamous NSCLC following progression on or after platinum-based chemotherapy.
Epidermal growth factor receptor tyrosine kinase inhibitors, gefitnib and erlotinib, are effective for advanced nonsmall-cell lung cancer with epidermal growth factor receptor gene mutation. However, interstitial lung disease induced by these drugs is sometimes fatal, and discontinuation of the medication is the principle approach once this occurs. There are, however, some reports of cases in which rechallenge of gefitinib or erlotinib was successful, and it remains unclear when or how rechallenge should be attempted. We report the first successful case of erlotinib rechallenge after both gefitinib- and erlotinib-induced interstitial lung diseases. Our case suggests that, in interstitial lung disease induced by an epidermal growth factor receptor tyrosine kinase inhibitor, rechallenge with concurrent glucocorticoid administration and gradual increase of dosage could be a clinical option if imaging does not show a diffuse alveolar damage pattern, and if no alternative therapy is available.
Erlonat (Erlotinib) should not be used by patients are lactose intolerant or have severely decreased kidney function. Also inform your physician if you have an ulcer, Gilbert's syndrome, or decreased liver function. These conditions may require reduced dosages or other adjustments to prevent potential problems from appearing.
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Adverse events were experienced by 65% of patients receiving erlotinib and 20% of patients receiving placebo. Most events on the erlotinib arm consisted of grade 2 or milder rash (60%) or diarrhea (18%), which is consistent with previous studies. Only 16% of patients receiving erlotinib required a dose reduction compared with 3% receiving placebo. There was no difference in overall quality of life measurements between the two groups. In post-study treatments, EGFR TKI use was more frequent in the group that received placebo (21%) compared with the group that received erlotinib (11%).
Erlotinib is metabolized predominantly by CYP3A4, and inhibitors of CYP3A4 would be expected to increase exposure. Co-treatment with the potent CYP3A4 inhibitor ketoconazole increases erlotinib AUC by 2/3. When TARCEVA was co-administered with ciprofloxacin, an inhibitor of both CYP3A4 and CYP1A2, the erlotinib exposure [AUC] and maximum concentration [C max ] increased by 39% and 17% respectively. Caution should be used when administering or taking TARCEVA with ketoconazole and other strong CYP3A4 inhibitors such as, but not limited to, atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, troleandomycin (TAO), voriconazole and grapefruit or grapefruit juice. [see Dosage and Administration (2.3 )] .
Phase I/II Study of HSP90 Inhibitor AUY922 and Erlotinib for EGFR -Mutant Lung Cancer With Acquired Resistance to Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors
On the other hand, the overexpression of p21 inhibits proliferation in mammalian cells and has been found to inhibit all cyclin-CDK complexes, suggesting that it is a cyclin-CDK inhibitor (16 ). p21 has demonstrated that the inhibitory control on cyclin-CDK complexes is mediated through its N-terminal domain and is distinct from its ability to bind PCNA (16 ). p21 plays an essential role in growth arrest after DNA damage, while its overexpression leads to cell cycle arrest, which prevents DNA damage (17 ). Erlotinib-mediated signaling is involved in the up-regulation of p21 (18 ). We demonstrated the overexpression of p21 in erlotinib-resistant cells (A549/ER cells) when compared to A549 cells (Fig. 3 ). Additionally, Ferrandiz et al have reported that p21-deficient colon cancer cells were more sensitive towards imatinib and gefitinib than parental cells (19 ). These results suggest that the overexpression of p21 may prevent erlotinib signaling in A549/ER cells.
Effect of Erl/GLE in BC cells with acquired and intrinsic Erlotinib resistance. A, B. rSUM-149 cells were treated with Erl, GLE or Erl/GLE for 72h and cell viability and CIs were calculated based on the IC 50 of each at a constant Erl:GLE (1:24) and at NCR (Erl+0.2 mg/mL-GLE). C. rSUM-149 cells were seeded in 3D (see Fig.2 ) and treated with vehicle, 2.0 µM-Erlotinib, 0.2 mg/mL-GLE or Erl/GLE for 72h. Micrographs were obtained with a 20x objective magnification at the same location. These represent the average of 10 photos taken by treatment. Scale bars = 100µm. D, E. MDA-MB-231 cells were treated with Erl, GLE or Erl/GLE for 72h and cell viability and CIs were calculated based on the IC 50 of each at a constant Erl:GLE (1:47) and at NCR (Erlotinib+0.2 mg/mL-GLE). Columns represent means ± SEM. Experiments were repeated at least three times. Significance against: Erlotinib (*) or GLE (ᶲ) ( P ≤0.05).
25 nM) (Supplementary Figure 12 ). Together, the data indicate that AXL kinase activation is necessary and sufficient to promote erlotinib resistance in these EGFR mutant NSCLC models.
An economic analysis was performed by the National Cancer Institute Canada Clinical Trials Group based on the BR.21 trial where patients were randomized to erlotinib or placebo after failing front-line therapy for advanced-stage NSCLC (40 ). This study was performed before EGFR mutational testing was available for patient selection.
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Does Erlotinib have any interaction with drugs?
In the erlotinib plus gemcitabine group, erlotinib dose reductions due to rash occurred in 2% of the erlotinib-treated patients, and 13% were dose reduced for any cause. Erlotinib dose was interrupted for more than 7 days due to rash in 5% of the patients, and 2% of the patients were permanently discontinued due to rash. Overall survival was not associated with erlotinib dose reductions, interruptions, or discontinuations due to rash.
Erlotinib kann auch als alleiniger Wirkstoff zur Weiterbehandlung zum Einsatz kommen, wenn Patienten nach vier Behandlungszyklen mit einer Platinverbindung wie beispielsweise Cisplatin keine Besserung zeigen.