肺癌

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     现在很多肺癌患者服用易瑞沙时担心的不仅仅是价格问题，更多的是耐药问题。肯定的说，易瑞沙会耐药，每个人出现耐药的时间长短不一，但肯定会出现，所以如果你在服用易瑞沙，就一定要考虑好耐药后的方案。以下是服用易瑞沙这几年总结出来的几点易瑞沙耐药后，可选择的继续治疗的方案与治疗用药。希望对患友们有帮助。
　　 易瑞沙耐药之后选择之前没有用过的化疗药物做化疗，这对于一些吃易瑞沙之前化疗方案不标准或者没有做化疗的病友可以考虑，但毕竟化疗对身体损伤太大，病人到了耐药阶段也承受不了太大的损伤，所以在化疗药物的选择上要尽量用副作用相对比较小的药物；
　   力比泰（ALIMTA）联合泰索帝或者顺柏等其它化疗药物，如果能有效控制病情了，可重新用回易瑞沙，可能易瑞沙仍然会有效（印度力比泰团购）。
　　 特罗凯(它塞瓦)（TARCEVA）联合阿瓦斯汀（AVASTIN），或联合其它化疗药物。这是论坛里病友讨论比较多的，但是TARCEVA与易瑞沙一样是单一靶点作用于表皮生长因子（EGF）的药理，易瑞沙耐药了，TARCEVA有效的可能性也比较小，而且一个月两万元的价格足以让人却步；
　　 可选择索拉非尼（多吉美）sorafenib——该药是治疗肾癌的药物，但用于非小细胞肺癌的Ⅲ期临床试验已经在2006年展开，我想之所以医生会推荐它在易瑞沙耐药之后使用，可能是因为该药是多靶点的靶向药物，和ZD6474一样是作用于表皮生长因子EGF和血管表皮生长因子VEGF的，这是优于易瑞沙的；
　　 当下讨论比较多的恩度，单用或者联合用药，这个药在病友间争议比较大，我的了解不是很全面，有不少医生会建议在易瑞沙耐药后使用恩度，但据一些使用过的病友反应，副作用比较大而且预后一般。最近群内又有病友反映恩度对于心脏的副作用非常大，大家一定要慎重；
　　 可选择易瑞沙二代Zactima(ZD6474)，它不仅作用于表皮生长因子同时作用于血管表皮因子的双通道抑制剂，虽然至今没有上市，但已经处于Ⅱ期临床试验阶段，值得去期待。目前国内只有在个别医院进行试验组，国内买不到，但已有病友在美国购买到；
　　 C－225，这段时间在与病友讨论易瑞沙耐药方案时几次听病友提及这个药，C－225也就是Erbitux（艾比特思；cetuximab），大致了解一下这个药适用于结肠癌和肺癌，资料里说该药是作用于表皮生长因子EGF，而达到减少血管表皮生长因子VEGF的生长，这一点与易瑞沙二代ZD6474（Zactima）的药理有相似之处，不知道是不是因为这个原因，而使它被医生作为易瑞沙耐药后的推荐。

==== 汉译英 ====

Many lung cancer patients taking Iressa Friends worry that the issue is not just price, more of a problem of drug resistance after treatment. Yes, Iressa will be resistance, the emergence of drug each person for varying periods of time, but it is bound to arise, so if you are taking Iressa, it is necessary to consider the program after a good resistance. Here is what I sum up the past few years taking Iressa Iressa resistance points out, the choice of continuing treatment program and treatment drug. Want to help suffering faithful.
Iressa-resistant, chose not been used prior to chemotherapy drugs chemotherapy, which Iressa for some food before the non-standard chemotherapy or no chemotherapy for sufferers can be considered, but, after all, too much damage on the body with chemotherapy, the patient to the resistance drug phase also can not afford too much damage, so the choice of chemotherapy drugs, we should try to use side-effects of the drug is relatively small;
Alimta (ALIMTA) combined chemotherapy drug Taxotere, or other, if they can effectively control the disease, and can be re-used back to Iressa may IRESSA will continue to be valid, but according to my observation, the direct force than the first-line or second-line Thailand's effect is better tolerated than in Thailand after the force there is no effective impression, but as one of the options limited after resistance is a need to focus on programs;
It Ceva (TARCEVA) combined Avastin (AVASTIN), or in combination with other chemotherapy drugs. This is a forum to discuss the more and more sufferers, but TARCEVA with Iressa as a single target for acting on the epidermal growth factor (EGF) in pharmacology, drug Iressa had, TARCEVA the possibility of an effective relatively small, but a the price of twenty thousand per month is enough to deter;
Choose Sorafenib (Nexavar) sorafenib - drug to treat kidney cancer drug, but for non-small cell lung cancer Phase Ⅲ clinical trials have been launched in 2006, I think the reason why a doctor would recommend it easy Rui Sha used after resistance, possibly because the drug is a multi-targeted drug targets, and as is the role of ZD6474 in the epidermal growth factor EGF and vascular epidermal growth factor VEGF, which is better than Iressa in;
Was much discussed at the moment ex degrees, alone or combination therapy, the drug in the patients concerned the dispute between the relatively large, I know not very comprehensive, there are many doctors recommended that after the use of Iressa-resistant En-degree, but according to some used the sufferers response, side effects, and prognosis is usually relatively large. Recently another group of sufferers within a degree reflect the ex side effects for the heart is very large, we must be careful;
Iressa choose second-generation Zactima (ZD6474), which not only act on the epidermal growth factor at the same time acting on the vascular epidermal factor dual-channel inhibitors, although there has been no market, but it is already in Phase Ⅱ clinical trials, it is worth to expect. Currently only the test group in individual hospitals, the domestic buy anything, but there are other sufferers in the United States to purchase;
C-225, this time with the sufferers to discuss the program of Iressa-resistant patients have mentioned this several times to listen to drug, C-225 is Erbitux (Erbitux; cetuximab), an overview of what this drug for colon cancer and lung cancer, data-ri, said the drug was acting on the epidermal growth factor EGF, while the goal of reducing blood vessel growth epidermal growth factor VEGF, which is the second generation with Iressa ZD6474 (Zactima) pharmacological similarities, do not know whether For this reason, while it was a doctor as recommended after the Iressa drug resistance.