{"id":118704,"date":"2019-07-02T11:55:50","date_gmt":"2020-04-20T10:01:12","guid":{"rendered":"http:\/\/www.05921.net\/index.php\/118704\/"},"modified":"2020-04-20T18:01:13","modified_gmt":"2020-04-20T10:01:13","slug":"970115742c","status":"publish","type":"post","link":"https:\/\/www.05921.net\/index.php\/118704\/","title":{"rendered":"\u56db\u5927\u521b\u65b0\u836f\u54c1\u8fce\u6765\u6625\u5929 \u60a3\u8005\u4fdd\u969c\u6307\u65e5\u53ef\u5f85"},"content":{"rendered":"
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\u7f16\u8005\u6309\uff1a<\/span><\/strong><\/span><\/p>\n


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\u8def\u6f2b\u6f2b\u5176\u4fee\u8fdc\u516e\uff0c\u521b\u65b0\u836f\u7269\u7684\u7814\u53d1\u662f\u4e00\u6761\u6f2b\u957f\u800c\u5145\u6ee1\u4e0d\u786e\u5b9a\u6027\u7684\u9053\u8def\u3002\u4f46\u836f\u7269\u521b\u65b0\u4e00\u65e6\u53d6\u5f97\u6210\u529f\uff0c\u5176\u6240\u5e26\u6765\u7684\u7ecf\u6d4e\u6548\u76ca\u548c\u793e\u4f1a\u6548\u76ca\u975e\u5e38\u663e\u8457\uff0c\u5c06\u6709\u52a9\u4e8e\u6539\u5584\u5168\u4eba\u7c7b\u7684\u5065\u5eb7\u3002\u76ee\u524d\u6211\u56fd\u9f13\u52b1\u521b\u65b0\u5df2\u6210\u4e3a\u4e3b\u65cb\u5f8b\uff0c\u521b\u65b0\u836f\u7269\u9762\u4e34\u7740\u524d\u6240\u672a\u6709\u7684\u673a\u9047\u3002\u533b\u4fdd\u65b9\u9762\u7684\u6539\u9769\u5982\u533b\u4fdd\u76ee\u5f55\u52a8\u6001\u8c03\u6574\u673a\u5236\u4e5f\u4f7f\u521b\u65b0\u836f\u7269\u66f4\u5feb\u8986\u76d6\u66f4\u591a\u4eba\u7fa4\uff0c\u672a\u6765\u53ef\u671f\u3002<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u6211\u56fd\u521b\u65b0\u836f\u9886\u57df\u5df2\u8fce\u6765\u53d1\u5c55\u7684\u6625\u5929\uff0c\u8fd1\u5e74\u6765\u968f\u7740\u533b\u6539\u5728\u836f\u54c1\u6ce8\u518c\u7ba1\u7406\u3001\u5ba1\u8bc4\u5ba1\u6279\u3001\u4e0a\u5e02\u8bb8\u53ef\u7b49\u65b9\u9762\u7684\u6539\u9769\u4e0d\u65ad\u63a8\u8fdb\uff0c\u521b\u65b0\u836f\u6b63\u5065\u5eb7\u53d1\u5c55\uff0c\u8fc8\u5165\u4e00\u4e2a\u65b0\u7684\u65f6\u4ee3\u3002\u540c\u65f6\uff0c\u8fdb\u53e3\u836f\u4e0a\u5e02\u52a0\u5feb\uff0c\u4fc3\u8fdb\u5883\u5916\u5df2\u4e0a\u5e02\u65b0\u836f\u5c3d\u5feb\u5728\u5883\u5185\u4e0a\u5e02\u3002\u6b64\u5916\uff0c\u533b\u6539\u4e2d\u5bf9\u4e8e\u836f\u54c1\u91c7\u8d2d\u548c\u533b\u4fdd\u8986\u76d6\u529b\u5ea6\u4ea6\u6301\u7eed\u6539\u9769\uff0c\u6240\u6709\u8fd9\u4e9b\u5de5\u4f5c\u90fd\u662f\u4e3a\u4e86\u8ba9\u60a3\u8005\u7528\u4e0a\u6240\u9700\u8981\u7684\u3001\u6709\u8d28\u91cf\u7684\u3001\u53ef\u8d1f\u62c5\u7684\u836f\u7269\u3002<\/span><\/p>\n


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\u5728\u8fd9\u79cd\u826f\u6027\u53d1\u5c55\u7684\u6c1b\u56f4\u4e2d\uff0c\u8bb8\u591a\u7814\u53d1\u9a71\u52a8\u7684\u8de8\u56fd\u4f01\u4e1a\u66f4\u52a0\u79ef\u6781\u52aa\u529b\u63a8\u8fdb\u4f18\u79c0\u521b\u65b0\u836f\u7269\u7684\u5f15\u5165\u548c\u836f\u7269\u53ef\u53ca\u6027\u7684\u63d0\u9ad8\uff0c\u8ba9\u4e2d\u56fd\u60a3\u8005\u80fd\u591f\u65e9\u671f\u83b7\u76ca\u3001\u6301\u4e45\u83b7\u76ca\u3001\u5145\u5206\u83b7\u76ca\u3002<\/span>\u7f57\u6c0f<\/span><\/strong>\u516c\u53f8\u8fd1\u671f\u5728\u4e2d\u56fd\u4e0a\u5e02\u4e86\u591a\u6b3e\u91cd\u78c5\u521b\u65b0\u836f\u7269\uff08<\/span>\u5e15\u59a5\u73e0\u5355\u6297\u3001\u963f\u6765\u66ff\u5c3c\u3001\u6258\u73e0\u5355\u6297\u3001\u827e\u7f8e\u8d5b\u73e0\u5355\u6297<\/span><\/strong>\uff09\uff0c\u4e3a\u60a3\u8005\u5e26\u6765\u83b7\u76ca\uff0c\u503c\u5f97\u6211\u4eec\u5173\u6ce8\u3002<\/span><\/span><\/p>\n<\/section>\n

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\u5e15\u59a5\u73e0\u5355\u6297<\/span><\/strong><\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u4f5c\u4e3a\u9996\u4e2a\u6291\u5236 HER2 \u5f02\u6e90\u4e8c\u805a\u5316\u7684\u5927\u5206\u5b50\u5355\u6297\uff0c\u5e15\u59a5\u73e0\u5355\u6297\u901a\u8fc7\u673a\u5236\u521b\u65b0\u663e\u8457\u964d\u4f4e\u590d\u53d1\u98ce\u9669\uff0c\u63d0\u9ad8\u60a3\u8005\u6cbb\u6108\u673a\u4f1a\uff0c\u4e3a\u9ad8\u590d\u53d1\u98ce\u9669 HER2 \u9633\u6027\u4e73\u817a\u764c\u60a3\u8005\u63d0\u4f9b\u552f\u4e00\u7cfb\u7edf\u6027\u6cbb\u7597\u9009\u62e9\uff0c\u83b7\u6743\u5a01\u6307\u5357\u4e00\u81f4\u63a8\u8350<\/span><\/p>\n


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\u3010\u60a3\u8005\u83b7\u76ca\u3011\uff1a<\/span><\/strong>\u56fd\u9645\u591a\u4e2d\u5fc3\u968f\u673a\u5bf9\u7167\u7814\u7a76 <\/span>APHINITY<\/span><\/strong> \u7814\u7a76\u8bc1\u5b9e\uff0c\u4e0e\u66f2\u59a5\u73e0\u5355\u6297\u5355\u836f\u65b9\u6848\u76f8\u6bd4\uff0c\u5e15\u59a5\u73e0\u5355\u6297\u8054\u5408\u66f2\u59a5\u73e0\u5355\u6297\u7684\u53cc\u9776\u65b9\u6848\u53ef\u663e\u8457\u964d\u4f4e HER2 \u9633\u6027\u4e73\u817a\u764c\u60a3\u8005\u7684\u590d\u53d1\u98ce\u9669\uff0c\u6dcb\u5df4\u7ed3\u9633\u6027\uff08LN+\uff09\u6216\u6fc0\u7d20\u53d7\u4f53\u9634\u6027\uff08HR-\uff09\u7684\u9ad8\u590d\u53d1\u98ce\u9669\u60a3\u8005\u83b7\u76ca\u66f4\u663e\u8457\uff0c<\/span>\u590d\u53d1\u6216\u6b7b\u4ea1\u98ce\u9669\u4e0b\u964d 23% \u548c 24%<\/span><\/strong>\u3002\u5176\u4e2d<\/span>\u4e2d<\/span><\/strong>\u56fd\u4eba\u7fa4\u83b7\u76ca\u66f4\u663e\u8457<\/span><\/strong>\uff0cLN+\u6216 HR-\u7684\u9ad8\u5371\u4eba\u7fa4<\/span>\u590d\u53d1\u6216\u6b7b\u4ea1\u98ce\u9669\u964d\u4f4e 45% \u548c 51%<\/span><\/strong>1,2<\/sup>\u3002<\/span><\/span><\/p>\n


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\"\u56db\u5927\u521b\u65b0\u836f\u54c1\u8fce\u6765\u6625\u5929
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\u3010\u6cbb\u7597\u5730\u4f4d\u3011\uff1a<\/span><\/strong>\u4e73\u817a\u764c\u53d1\u75c5\u7387\uff0841.82\/10 \u4e07\uff09\u4f4d\u5c45\u5973\u6027\u6076\u6027\u80bf\u7624\u9996\u4f4d\uff0c\u7ea6 25% \u4e3a HER2 \u9633\u6027\uff0c\u6076\u6027\u7a0b\u5ea6\u66f4\u9ad8\u3002\u4e2d\u56fd\u60a3\u8005\u5e74\u8f7b\u5316\uff0c\u521d\u8bca\u9ad8\u5371\u3001\u4e2d\u9ad8\u5371\u60a3\u8005\u591a\uff0c\u6613\u590d\u53d1\uff0c\u65e9\u671f\u4e34\u5e8a\u6cbb\u6108\u9700\u6c42\u66f4\u9ad8\u3002\u4e0e\u76ee\u5f55\u5185\u66f2\u59a5\u73e0\u5355\u6297\u8054\u7528\u662f<\/span>\u76ee\u524d\u552f\u4e00<\/span><\/strong>\u7528\u4e8e\u9ad8\u590d\u53d1\u98ce\u9669 HER2 \u9633\u6027\u65e9\u671f\u4e73\u817a\u764c\u60a3\u8005\u7684\u8f85\u52a9\u6cbb\u7597\u65b9\u6848 3<\/sup>\u3002\u73b0\u6709\u5355\u7eaf\u7684\u8d6b\u8d5b\u6c40\u6cbb\u7597\u4e0d\u80fd\u6ee1\u8db3 HER2 \u9633\u6027\u4e73\u817a\u764c\u7cfb\u7edf\u6027\u6cbb\u7597\u9700\u6c42 4-6<\/sup>\u3002\u5e15\u59a5\u73e0\u5355\u6297+\u66f2\u59a5\u73e0\u5355\u6297\u4e3a\u76ee\u524d NCCN\u3001ASCO\u3001CSCO\u3001\u4e73\u817a\u764c\u8bca\u7597\u89c4\u8303\uff082018 \u5e74\u7248\uff09\u7b49\u4e34\u5e8a<\/span>\u6307\u5357\u4e00\u81f4\u63a8\u8350<\/span><\/strong>\u7684\u9ad8\u590d\u53d1\u98ce\u9669 HER2 \u9633\u6027\u65e9\u671f\u4e73\u817a\u764c\u7684\u552f\u4e00 \u53cc\u9776\u8054\u5408\u8f85\u52a9\u6cbb\u7597\u65b9\u6848 3,7-9<\/sup>\u3002<\/span><\/span><\/p>\n


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\u3010\u836f\u54c1\u521b\u65b0\u3011\uff1a<\/span><\/strong>\u5e15\u59a5\u73e0\u5355\u6297\u662f<\/span>\u9996\u4e2a\u6291\u5236 HER2 \u5f02\u6e90\u4e8c\u805a\u5316\u7684\u5927\u5206\u5b50\u5355\u6297<\/span><\/strong>\uff0c\u4e0e\u66f2\u59a5\u73e0\u5355\u6297\u7ed3\u5408\u4e0d\u540c\u7684 HER2 \u4f4d\u70b9\uff0c\u53ef\u4ee5\u5168\u9762\u963b\u65ad HER2 \u901a\u9053\u4fe1\u53f7\u4f20\u5bfc\u3002<\/span><\/span><\/p>\n


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\u963f\u6765\u66ff\u5c3c<\/span><\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u6cbb\u7597 ALK \u9633\u6027\u5c40\u90e8\u665a\u671f\u6216\u8f6c\u79fb\u6027\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\uff0c\u80ba\u764c\u9886\u57df\u65e0\u8fdb\u5c55\u751f\u5b58\u671f\uff0834.8 \u4e2a\u6708\uff09\u6700\u957f\u7684\u836f\u54c1\uff0c\u66f4\u5f3a\u7684\u5165\u8111\u80fd\u529b\uff0c\u6709\u6548\u63a7\u5236\u548c\u9884\u9632\u9885\u5185\u8fdb\u5c55\u3002\u6743\u5a01\u6307\u5357\u552f\u4e00\u660e\u786e\u6807\u6ce8\u300c\u4f18\u9009\u300d\u4e00\u7ebf\u6cbb\u7597\u65b9\u6848\uff0c\u8ba9\u80ba\u764c\u771f\u6b63\u53d8\u6210\u6162\u6027\u75c5<\/span><\/p>\n


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\u3010\u60a3\u8005\u83b7\u76ca\u3011\uff1a<\/span><\/strong>\u5168\u7403\u591a\u4e2d\u5fc3\u968f\u673a\u5bf9\u7167 III \u671f\u7814\u7a76 <\/span>ALEX<\/span><\/strong> \u5728 ALK \u9633\u6027\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\u4e2d\uff0c\u5934\u5bf9\u5934\u6bd4\u8f83\u4e86\u65b0\u4e00\u4ee3 ALK \u6291\u5236\u5242\u963f\u6765\u66ff\u5c3c\u548c\u514b\u5511\u66ff\u5c3c\uff0c\u7ed3\u679c\u663e\u793a\uff0c\u963f\u6765\u66ff\u5c3c\u7ec4\u7684\u65e0\u8fdb\u5c55\u751f\u5b58\u671f<\/span>\uff08PFS\uff09\u8fbe\u5230 34.8 \u4e2a\u6708\uff0c\u662f\u73b0\u6709\u6807\u51c6\u6cbb\u7597\uff08\u514b\u5511\u66ff\u5c3c\uff09\u7684 3 \u500d\u4ee5\u4e0a<\/span><\/strong>\u3002\u6b64\u5916\uff0c\u963f\u6765\u66ff\u5c3c\u53ef\u4ee5\u6709\u6548\u5730\u7a7f\u900f\u8840\u8111\u5c4f\u969c\uff0c<\/span>\u6709\u6548\u63a7\u5236\u8111\u90e8\u75c5\u7076\uff0c\u9884\u9632\u9885\u5185\u8fdb\u5c55<\/span><\/strong>\u3002\u4e0e\u6b64\u540c\u65f6\uff0c\u963f\u6765\u66ff\u5c3c\u7684\u5b89\u5168\u6027\u66f4\u4f18 10-13<\/sup>\u3002  <\/span><\/span><\/p>\n

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\"\u56db\u5927\u521b\u65b0\u836f\u54c1\u8fce\u6765\u6625\u5929<\/p>\n

\u963f\u6765\u66ff\u5c3c\u964d\u4f4e\u4e2d\u67a2\u795e\u7ecf\u7cfb\u7edf\u8fdb\u5c55\u53d1\u751f\u7387\uff0c\u5ef6\u7f13\u8111\u8f6c\u79fb\u53d1\u751f\uff0c\u8282\u7ea6\u4e8c\u7ebf\u6cbb\u7597\uff08TKI\/\u5316\u7597\uff09\u8d39\u7528\u3001\u8111\u8f6c\u79fb\u68c0\u6d4b\u53ca\u6cbb\u7597\u8d39\u7528\u7b49\u76f4\u63a5\u8d39\u7528\u548c\u60a3\u8005\u8bef\u5de5\u3001\u7167\u62a4\u76f8\u5173\u7b49\u95f4\u63a5\u8d39\u7528\u3002\u4e2d\u56fd\u836f\u7269\u7ecf\u6d4e\u5b66\u7814\u7a76\u663e\u793a\u963f\u6765\u66ff\u5c3c\u6bd4\u514b\u5511\u66ff\u5c3c<\/span>\u5177\u6709\u6210\u672c\u6548\u679c\u4f18\u52bf<\/span><\/strong> 14<\/sup>\u3002<\/span><\/span><\/p>\n


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\u3010\u6cbb\u7597\u5730\u4f4d\u3011\uff1a<\/span><\/strong>\u80ba\u764c\u662f\u4e2d\u56fd\u53d1\u75c5\u7387\u53ca\u6b7b\u4ea1\u7387\u6700\u9ad8\u7684\u80bf\u7624\uff0c\u7ea6 85% \u4e3a NSCLC\uff0cALK+\u60a3\u8005\u5360 5-7%\u3002\u60a3\u8005\u5e74\u8f7b\u5316\uff08\u5e73\u5747\u53d1\u75c5 50 \u5c81\u5de6\u53f3\uff09\uff0c\u9884\u540e\u5dee\uff0c\u6613\u53d1\u751f\u8111\u8f6c\u79fb\uff0c\u75be\u75c5\u8d1f\u62c5\u91cd\u3002\u73b0\u6709\u836f\u7269\u514b\u5511\u66ff\u5c3c\uff0810.9 \u4e2a\u6708\uff09\u3001\u585e\u745e\u66ff\u5c3c\uff0816.6 \u4e2a\u6708\uff09\u7684 PFS \u6709\u9650\uff0c\u4e0d\u80fd\u6709\u6548\u9884\u9632\u4e0e\u6cbb\u7597\u8111\u8f6c\u79fb\uff0c\u65e0\u6cd5\u6ee1\u8db3\u6cbb\u7597\u9700\u6c42\u3002\u963f\u6765\u66ff\u5c3c\u662f NCCN\u3001ESMO\u3001CSCO \u63a8\u8350\u7684<\/span>\u4e00\u7ebf\u6807\u51c6\u6cbb\u7597\u65b9\u6848<\/span><\/strong>\uff0c\u5176\u4e2d NCCN \u53ca CSCO \u6307\u5357\u4e2d<\/span>\u552f\u4e00\u660e\u786e\u6807\u6ce8\u4e3a\u300c\u4f18\u9009\u300d\u7684\u6cbb\u7597\u65b9\u6848<\/span><\/strong> 15-17<\/sup>\u3002<\/span><\/span><\/p>\n


<\/p>\n

\u3010\u836f\u54c1\u521b\u65b0\u3011\uff1a<\/span><\/strong>\u963f\u6765\u66ff\u5c3c\u662f\u9009\u62e9\u6027\u4e13\u4e00\u7684 ALK \u6291\u5236\u5242\uff0c\u5e26\u6765<\/span>\u8d85\u957f PFS<\/span><\/strong>\u3002\u5177\u6709<\/span>\u66f4\u5f3a\u7684\u5165\u8111\u80fd\u529b<\/span><\/strong>\uff0c\u9ad8\u8840\u8111\u5c4f\u969c\u900f\u8fc7\u7387\uff0c\u6709\u6548\u964d\u4f4e\u8111\u8f6c\u79fb\u7684\u53d1\u751f\u6216\u8fdb\u5c55\u98ce\u9669\u3002\u53e3\u670d\u7ed9\u836f\uff0c\u4f7f\u7528\u66f4\u4fbf\u5229\uff0c\u60a3\u8005\u4f9d\u4ece\u6027\u66f4\u597d\u3002<\/span><\/span><\/p>\n


<\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n


<\/p>\n


<\/p>\n

\n
\n
\n
\n
<\/section>\n
\n

\u6258\u73e0\u5355\u6297<\/span><\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n


<\/p>\n

\u5168\u65b0\u9776\u70b9\u4f5c\u7528\u4e8e\u767d\u4ecb\u7d20-6 \u7684\u751f\u7269\u5236\u5242\uff0c\u4e3a\u4e2d\u91cd\u5ea6\u7c7b\u98ce\u6e7f\u60a3\u8005\u5e26\u6765\u7efc\u5408\u83b7\u76ca\uff1b\u662f\u513f\u7ae5\u5168\u8eab\u578b\u5e7c\u5e74\u7279\u53d1\u6027\u5173\u8282\u708e\u552f\u4e00\u83b7\u6279\u6cbb\u7597\u836f\u7269\u586b\u8865\u6cbb\u7597\u7a7a\u767d\uff0c\u4f7f\u513f\u7ae5\u60a3\u8005\u53ef\u4ee5\u8ffd\u8d76\u751f\u957f\u3002<\/span><\/p>\n


<\/p>\n

\u7c7b\u98ce\u6e7f\u6027\u5173\u8282\u708e (RA)<\/strong><\/span><\/p>\n


<\/p>\n

\u3010\u60a3\u8005\u83b7\u76ca\u3011\uff1a<\/span><\/strong>\u4e2d\u56fd\u591a\u4e2d\u5fc3\u968f\u673a\u53cc\u76f2\u5e73\u884c\u5bf9\u7167 III \u671f\u4e34\u5e8a\u8bd5\u9a8c <\/span>TRACE<\/strong> \u7814\u7a76\u663e\u793a\uff0c\u6258\u73e0\u5355\u6297\u5feb\u901f\u6297\u708e\u5e76\u6301\u7eed\u589e\u6548\uff0c\u53ef\u6291\u5236\u5e76\u6709\u6548\u4fee\u590d\u7c7b\u98ce\u6e7f\u5173\u8282\u708e\uff08RA\uff09\u5173\u8282\u9aa8\u7834\u574f\uff0c\u540c\u65f6\u6539\u5584\u5168\u8eab\u5408\u5e76\u75c7\u72b6\uff08\u5982\u8d2b\u8840\u3001\u9aa8\u8d28\u758f\u677e\u3001\u6291\u90c1\u7b49\uff09\uff0c\u4f7f\u60a3\u8005\u8fbe\u5230<\/span>\u7efc\u5408\u83b7\u76ca<\/strong>\u3002\u603b\u4f53\u5b89\u5168\u6027\u826f\u597d\uff0c\u7ed3\u6838\u548c\u80bf\u7624\u7684\u53d1\u751f\u98ce\u9669\u6700\u4f4e 24-31\uff0c<\/sup>\u4e14\u6258\u73e0\u5355\u6297<\/span>\u6210\u672c\u6548\u679c\u4f18\u52bf<\/strong>\u4f18\u4e8e\u80bf\u7624\u574f\u6b7b\u56e0\u5b50\u6291\u5236\u5242\uff08TNFi\uff09\u3002<\/span><\/span><\/p>\n


<\/p>\n

\u3010\u6cbb\u7597\u5730\u4f4d\u3011\uff1a<\/span><\/strong>\u6211\u56fd\u60a3\u8005\u9ad8\u8fbe 540 \u4e07\uff0c\u5973\u6027\u591a\u53d1\uff0c\u7537: \u5973\u4e3a 1:4\uff0c\u4ee5 30-50 \u5c81\u4e3a\u53d1\u75c5\u9ad8\u5cf0\u3002RA \u662f\u4e00\u79cd<\/span>\u9ad8\u81f4\u6b8b\u3001\u5168\u8eab\u6027<\/strong>\u81ea\u8eab\u514d\u75ab\u75c5\uff0c\u4ee5\u5173\u8282\u7834\u574f\u4e3a\u662f\u7279\u5f81\u8868\u73b0\uff0c\u4f34\u968f\u5168\u8eab\u708e\u75c7\u53cd\u5e94\uff0c<\/span>\u60a3\u8005\u751f\u6d3b\u8d28\u91cf\u8f83\u5dee<\/strong>\u3002\u65e2\u5f80\u751f\u7269\u5236\u5242\u4e0d\u80fd\u6ee1\u8db3\u4e34\u5e8a\u6cbb\u7597\u9700\u6c42\uff0c\u5982\u4f20\u7edf TNFi \u6cbb\u7597 6 \u4e2a\u6708\u65f6 46.4% \u60a3\u8005\u5e94\u7b54\u4e0d\u8db3\u3002<\/span>\u767d\u4ecb\u7d20-6\uff08IL-6\uff09\u4f5c\u4e3a\u65b0\u7684 RA \u6cbb\u7597\u9776\u70b9<\/strong>\uff0cIL-6 \u53d7\u4f53\u5355\u514b\u9686\u6297\u4f53\u7684\u7597\u6548\u548c\u5b89\u5168\u6027\u66f4\u4f73\u3002\u56fd\u5185\u5916\u6743\u5a01\u6cbb\u7597\u6307\u5357\u5747\u63a8\u8350\u6258\u73e0\u5355\u6297\u4f5c\u4e3a\u6cbb\u7597 RA <\/span>\u4e00\u7ebf\u751f\u7269\u5236\u5242<\/strong> 32,33<\/sup>\u3002\u300a2018 \u7248\u4e2d\u56fd\u7c7b\u98ce\u6e7f\u5173\u8282\u708e\u8bca\u7597\u6307\u5357\u300b\u4e2d\uff0c\u5bf9\u4f20\u7edf\u5408\u6210 DMARDs \u53cd\u5e94\u4e0d\u8db3\u7684 RA \u60a3\u8005\uff0c\u4e5f\u5efa\u8bae\u4f20\u7edf\u5408\u6210 DMARDs \u8054\u5408\u6258\u73e0\u5355\u6297\u8fdb\u884c\u6cbb\u7597 34<\/sup>\u3002<\/span><\/span><\/p>\n


<\/p>\n

\u513f\u7ae5\u5168\u8eab\u578b\u5e7c\u5e74\u7279\u53d1\u6027\u5173\u8282\u708e (sJIA)<\/strong><\/span><\/p>\n


<\/p>\n

\u3010\u60a3\u8005\u83b7\u76ca\u3011\uff1a<\/span><\/strong>\u5168\u7403\u5173\u952e\u6027\u4e34\u5e8a\u8bd5\u9a8c <\/span>TENDER<\/strong> \u7814\u7a76\u663e\u793a\uff0c\u6258\u73e0\u5355\u6297\u53ef<\/span>\u5168\u9762\u63a7\u5236<\/strong>\u75c7\u72b6\uff0c\u5feb\u901f\u51cf\u505c\u6fc0\u7d20\uff0c\u6cbb\u7597 12 \u5468\uff0c85.3% \u60a3\u513f\u5b9e\u73b0 ACR30 \u5e94\u7b54\u4e14\u65e0\u53d1\u70ed\uff1b<\/span>\u8ffd\u8d76\u751f\u957f<\/strong>\uff0c\u6cbb\u7597 1 \u5e74\u540e\uff0c\u60a3\u513f\u5e73\u5747\u8eab\u9ad8\u589e\u957f\u901f\u7387\u5df2\u9ad8\u4e8e\u5065\u5eb7\u540c\u9f84\u513f\u7ae5\uff1b<\/span>\u603b\u4f53\u5b89\u5168\u6027\u826f\u597d<\/strong>\uff0c\u4e0d\u826f\u53cd\u5e94\u53d1\u751f\u7387\u4f4e\uff1b\u51cf\u5c11\u60a3\u8005\u5408\u5e76\u75c7\u72b6 24,35,36<\/sup>\u3002<\/span><\/span><\/p>\n


<\/p>\n

\u3010\u6cbb\u7597\u5730\u4f4d\u3011\uff1a<\/span><\/strong>\u5168\u8eab\u578b\u5e7c\u5e74\u7279\u53d1\u6027\u5173\u8282\u708e\uff08sJIA\uff09<\/span>\u81f4\u6b7b\u7387\u4e0e\u81f4\u6b8b\u7387\u9ad8<\/strong>\uff0c\u75be\u75c5\u8d1f\u62c5\u4e25\u91cd\u3002\u4f20\u7edf\u7528\u836f\u6548\u679c\u4e0d\u4f73\uff0c\u6258\u73e0\u5355\u6297\u662f\u4e2d\u56fd<\/span>\u76ee\u524d\u552f\u4e00\u83b7\u6279\u6cbb\u7597 sJIA \u7684\u751f\u7269\u5236\u5242<\/strong>\u836f\u7269\uff0c\u586b\u8865\u4e34\u5e8a\u7a7a\u767d\u3002<\/span><\/span><\/p>\n


<\/p>\n

\u3010\u836f\u54c1\u521b\u65b0\u3011\uff1a<\/span><\/strong>\u5168\u7403\u9996\u4e2a\u83b7\u6279\u4e14\u76ee\u524d\u4e2d\u56fd\u552f\u4e00\u7684<\/span>\u6297\u4eba IL-6 \u53d7\u4f53\u4eba\u6e90\u5316\u5355\u514b\u9686\u6297\u4f53<\/strong>\uff0c\u53ef\u7279\u5f02\u6027\u7ed3\u5408 IL-6 \u7684\u53ef\u6eb6\u6027\u53d7\u4f53\u548c\u819c\u53d7\u4f53\uff0c\u4ee4 IL-6 \u65e0\u6cd5\u7ed3\u5408\u53d7\u4f53\uff0c\u8fdb\u800c\u963b\u65ad\u5176\u751f\u7269\u5b66\u6d3b\u6027\u3002<\/span><\/span><\/p>\n


<\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n


<\/p>\n


<\/p>\n

\n
\n
\n
\n
<\/section>\n
\n

\u827e\u7f8e\u8d5b\u73e0\u5355\u6297<\/span><\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n


<\/p>\n

\u8840\u53cb\u75c5\u9886\u57df 20 \u5e74\u6765\u9996\u4e2a\u7a81\u7834\u6027\u521b\u65b0\u836f\u7269\uff0c\u76ee\u524d\u4e2d\u56fd\u552f\u4e00\u975e\u56e0\u5b50\u7c7b\u7684\u4eba\u6e90\u5316\u53cc\u7279\u5f02\u6027\u5355\u514b\u9686\u6297\u4f53\uff0c\u5b9e\u73b0\u96f6\u6cbb\u7597\u51fa\u8840\uff0c\u586b\u8865\u4f34\u6291\u5236\u7269 A \u578b\u8840\u53cb\u75c5\u5e38\u89c4\u9884\u9632\u6cbb\u7597\u7a7a\u767d<\/span><\/p>\n


<\/p>\n

\u3010\u60a3\u8005\u83b7\u76ca\u3011\uff1a<\/span><\/strong>\u4e24\u9879\u5927\u578b\u5173\u952e\u4e34\u5e8a\u8bd5\u9a8c <\/span>HAVEN1 \u548c HAVEN2<\/span><\/strong> <\/strong>\u8bc1\u5b9e 12 \u5c81\u4ee5\u4e0a\u60a3\u8005 62.9% \u5b9e\u73b0<\/span>\u96f6\u51fa\u8840<\/span><\/strong>\uff0c12 \u5c81\u4ee5\u4e0b\u60a3\u8005 77% \u5b9e\u73b0\u96f6\u51fa\u8840\uff0c\u5e74\u5316\u51fa\u8840\u6b21\u6570\u4ec5 0.3\u3002\u5b89\u5168\u6027\u53ca\u8010\u53d7\u6027\u826f\u597d\uff0c\u4e0d\u826f\u53cd\u5e94\u53ef\u9632\u53ef\u63a7 18-21<\/sup>\u3002<\/span><\/span><\/p>\n


<\/p>\n

\"\u56db\u5927\u521b\u65b0\u836f\u54c1\u8fce\u6765\u6625\u5929<\/p>\n


<\/p>\n

\u9664\u4e86\u7597\u6548\u4f18\u52bf\u4ee5\u5916\uff0c\u827e\u7f8e\u8d5b\u73e0\u5355\u6297\u8fd8\u663e\u793a\u51fa\u5353\u8d8a\u7684<\/span>\u836f\u7269\u7ecf\u6d4e\u4f18\u52bf<\/span><\/strong>\uff1a\u663e\u8457\u51cf\u5c11\u9891\u7e41\u51fa\u8840\u4e8b\u4ef6\u5f15\u8d77\u7684\u76f4\u63a5\u6cbb\u7597\u6210\u672c\uff1b\u76ae\u4e0b\u6ce8\u5c04\u6bcf\u5468\u4e00\u6b21\uff0c\u66ff\u4ee3\u9700\u8981\u6bcf\u5468 2\uff5e3 \u6b21\u9891\u7e41\u9759\u8109\u6ce8\u5c04\u7684\u6309\u9700\u6cbb\u7597\u836f\u7269\uff0c\u8282\u7701\u4e86\u76f8\u5173\u533b\u7597\u8d44\u6e90\u4f7f\u7528\u53ca\u8d39\u7528\u3002\u663e\u8457\u6539\u5584\u60a3\u8005\u751f\u6d3b\u8d28\u91cf\uff0c\u4f7f\u60a3\u8005\u56de\u5f52\u6b63\u5e38\u751f\u6d3b\uff0c\u51cf\u5c11\u95f4\u63a5\u6210\u672c\uff0c\u7279\u522b\u662f\u513f\u7ae5\u60a3\u8005\uff0c\u51cf\u5c11\u8bef\u5b66\u65f6\u95f4\u53ca\u7167\u987e\u8005\u8bef\u5de5\u65f6\u95f4\u3002\u56fd\u5916\u836f\u7269\u7ecf\u6d4e\u5b66\u8bc4\u4ef7\u663e\u793a\uff0c\u6709 FVIII \u6291\u5236\u7269\u7684 A \u578b\u8840\u53cb\u75c5\u60a3\u8005\u4f7f\u7528\u827e\u7f8e\u8d5b\u73e0\u5355\u6297\u9884\u9632\u6cbb\u7597\uff0c\u663e\u8457\u8282\u7701\u56e0\u51fa\u8840\u4e8b\u4ef6\u5f15\u8d77\u7684\u533b\u7597\u6210\u672c\uff0c\u5e76\u51cf\u5c11\u751f\u4ea7\u529b\u635f\u5931\uff0c\u9884\u7b97\u5f71\u54cd\u53ef\u63a7\uff0c\u5177\u6709\u6781\u9ad8\u7ecf\u6d4e\u6027 22<\/sup>\u3002<\/span><\/span><\/p>\n


<\/p>\n

\u3010\u6cbb\u7597\u5730\u4f4d\u3011\uff1a<\/span><\/strong>A \u578b\u8840\u53cb\u75c5\u4f34\u6291\u5236\u7269\u53d1\u75c5\u7f55\u89c1\u4e14\u4e25\u91cd\uff0c\u6b7b\u4ea1\u98ce\u9669\u4e0a\u5347 70%\uff0c\u75be\u75c5\u8d1f\u62c5\u662f\u65e0\u6291\u5236\u7269\u60a3\u8005\u7684 3-5 \u500d\u3002\u73b0\u6709\u6309\u9700\u6cbb\u7597\u836f\u7269\u65e0\u6cd5\u6ee1\u8db3\u8fbe\u6807\u6cbb\u7597\u9700\u6c42\uff0c\u5b9e\u73b0\u96f6\u51fa\u8840\u3002\u76ee\u524d\uff0c\u56fd\u5185\u5916\u6743\u5a01\u6307\u5357\u5747\u5c06\u9884\u9632\u6cbb\u7597\u4f5c\u4e3a A \u578b\u8840\u53cb\u75c5\u7684\u63a8\u8350\u6cbb\u7597\u65b9\u5f0f\uff0c\u5bf9\u4e8e\u4e2d\u56fd\u6709 FVIII \u6291\u5236\u7269\u7684\u60a3\u8005\uff0c\u7f3a\u4e4f\u6709\u6548\u5730\u3001\u53ef\u957f\u671f\u7528\u4e8e\u9884\u9632\u6cbb\u7597\u7684\u836f\u7269\uff0c\u6025\u9700\u65b0\u836f\u586b\u8865\u4e34\u5e8a\u7a7a\u767d 23<\/sup>\u3002\u827e\u7f8e\u8d5b\u73e0\u5355\u6297\u7684\u4e0a\u5e02\uff0c\u6210\u4e3a<\/span>\u4e2d\u56fd\u76ee\u524d\u552f\u4e00\u83b7\u6279<\/span><\/strong>\u7528\u4e8e\u5b58\u5728\u51dd\u8840\u56e0\u5b50\u2167\u6291\u5236\u7269\u7684 A \u578b\u8840\u53cb\u75c5\u5e38\u89c4\u9884\u9632\u6027\u6cbb\u7597\u7684\u836f\u7269\u3002<\/span><\/span><\/p>\n


<\/p>\n

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1. \u5e15\u59a5\u73e0\u5355\u6297\u8bf4\u660e\u4e66<\/span><\/p>\n

2. Von Minckwitz G, et al. N Engl J Med 2017; 377:122-131.<\/span><\/p>\n

3. \u56fd\u5bb6\u536b\u5065\u59d4\u4e73\u817a\u764c\u8bca\u7597\u89c4\u8303\uff082018\u5e74\u7248\uff09 <\/span><\/p>\n

4. Perez EA, et al. J Clin Oncol. 2014;32(33):3744-3752.<\/span><\/p>\n

5. Slamon D, et al. Cancer Res. 2016;76(4 Supplement):S5-04-S5-04.<\/span><\/p>\n

6. Cameron D, et al. Lancet. 2017;389(10075):1195-1205.<\/span><\/p>\n

7. NCCN Breast Cancer Guidelines. Version 1, 2018 \u2013March 20, 2018<\/span><\/p>\n

8. Selection of Optimal Adjuvant Chemotherapy and Targeted Therapy for Early Breast Cancer: ASCO Clinical Practice Guideline Focused Update<\/span><\/p>\n

9. \u4e2d\u56fd\u4e34\u5e8a\u80bf\u7624\u5b66\u4f1a\uff08CSCO\uff09\u4e73\u817a\u764c\u8bca\u7597\u6307\u5357(2018.V1)<\/span><\/p>\n

10. \u76d0\u9178\u963f\u6765\u66ff\u5c3c\u80f6\u56ca\u8bf4\u660e\u4e66<\/span><\/p>\n

11. Camidge, et al. Updated efficacy and safety data from the global phase III ALEX study of alectinib (ALC) vs crizotinib (CZ) in untreated advanced ALK+ NSCLC. ASCO 2018 Poster number; 9043<\/span><\/p>\n

12. Costa DB, et al. J Clin Oncol. 2011;29(15): e443-5<\/span><\/p>\n

13. Peters S, et al. N Engl J Med. 2017;377(9):829-838.<\/span><\/p>\n

14. Cost-Effectiveness Study of Alectinib versus Crizotinib in First-Line Treatment for Anaplastic Lymphoma Kinase-Positive Advanced NSCLC in China, 2019 ISPOR, PCN135.<\/span><\/p>\n

15. NCCN Guidelines. Non-Small Lung Cancer v4. 2018;<\/span><\/p>\n

16. Novello S, et al. Ann Oncol. 2016 Sep;27(suppl 5):v1-v27.<\/span><\/p>\n

17. CSCO \u539f\u53d1\u6027\u80ba\u764c\u8bca\u7597\u6307\u53572018\u7248<\/span><\/p>\n

18. \u827e\u7f8e\u8d5b\u73e0\u5355\u6297\u6ce8\u5c04\u6db2\u8bf4\u660e\u4e66<\/span><\/p>\n

19. Oldenburg J, et al. N Engl J Med. 2017;377(9):809-818.<\/span><\/p>\n

20. FDA. HEMLIBRA (emicizumab -kxwh) injection, for sub cutaneous use. FDA label. 2017<\/span><\/p>\n

21.YoungG,etl.AmSoc Hematology. 2018. https:\/\/ash.confex.co m\/ash\/2018\/webprogram\/Paper118153.html.<\/span><\/p>\n

22. Emicizumab for Hemophilia A with Inhibitors: Effectiveness and Value. https:\/\/icer-review.org\/wp-content\/uploads\/2017\/08\/ICER_Hemophilia_Evidence_Report_031518.pdf.<\/span><\/p>\n

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25. Schett G, et al. 2018 EULAR: FRI0050.<\/span><\/p>\n

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27. Paul SK, et al. Semin Arthritis Rheum. 2018;47(4):478-484.<\/span><\/p>\n

28. \u9648\u4e50\u950b\u7b49. \u4e2d\u534e\u98ce\u6e7f\u75c5\u5b66\u6742\u5fd7. 2015;19(2):115-118.<\/span><\/p>\n

29. Yazici Y, et al. Ann Rheum Dis. 2012;17(2):198-205.<\/span><\/p>\n

30. Mok CC, et al. International Journal of Rheumatic Diseases 2014; 17(3): 1\u20138.<\/span><\/p>\n

31. Curtis JR, et al. Ann Rheum Dis. 2016;75(10):1843-7.<\/span><\/p>\n

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34. \u4e2d\u534e\u533b\u5b66\u4f1a\u98ce\u6e7f\u75c5\u5b66\u5206\u4f1a. 2018\u4e2d\u56fd\u7c7b\u98ce\u6e7f\u5173\u8282\u708e\u8bca\u7597\u6307\u5357. \u4e2d\u534e\u5185\u79d1\u6742\u5fd7. 2018;57(4):242-251.<\/span><\/p>\n

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36. De Benedetti F et al. N Engl J Med. 2012;367(25):2385-95.<\/span><\/p>\n


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