avatar
i*y
2
一年前在此发帖咨询得到一些很好的帮助。非常感谢!现想就一些新情况咨询懂医的网
友。
我父亲有长期烟史,壮年时得过肺结核。2003年底发现肺右下叶背段病灶,各种测试包
括同位素都无法确诊。2004年6月在胸腔镜辅助下手术,取样确定为癌症,改行右肺中
下页切除术,诊断是“原发性支气管肺癌,肺泡细胞癌T2N0M0ⅠB KPS90分”。随后做
了几
轮化疗。
这轮治疗后虽有很小肺部病灶,医生不建议其它治疗,病灶发展缓慢。2007开始一直服
用特罗凯似对存在的病灶有抑制作用。2011年5月左右起有骨转移症状,进行针对性放
疗似有效。2011年12月出现一些脑转移,全脑放疗几个月后检查似有较好抑制作用。
2012年1月用2004年(7年半前)手术取出的瘤块做基因测序显示有EGFR变异,无ALK变
异。(不知现在体内的癌细胞会否有进一步变异?)
在这些治疗过程中及至今仍继续服用特罗凯,因为医生认为虽有转移但特罗凯可能仍起
一定作用,所以放疗等都是用的姑息疗法(相对少些剂量),也不曾再用放疗。
2012年早些显示有其它部位骨转移,按医生推荐在继续服用特罗凯同时每月用择泰(唑
来膦酸)注射,昨天刚注射完最后一次(第6次)。此过程中似因药物作用病人胃口明
显下降,体重也有所减轻。另外在医生推荐下做了两次CIK免疫疗法。准备在约一个月
后做一次全面检查看病情进展。
我的主要问题是:
1。现在考虑进一步治疗的话是否化疗还是首选?(感觉我父亲现在的身体虽比以前虚
弱些,应该还是经得起化疗。)
2。是否需要考虑继续进行DC-CIK疗法?查了一下似乎此法在美国和其它国家并没有临
床应用?国内有几个医院做得挺多。不知是否足够安全和有效?不知是否知道国内哪个
医院此技术成熟些?
3。考虑病人可能已对特罗凯有抗药性,是否有新的靶向药物可以考虑?
希望懂行的网友能分享一些信息和建议,不胜感激!谢谢!
avatar
i*c
3
f1 2003年来美,07年开始1年的opt,08年10月开始h1.
07-08 opt期间,交了一年的ssn和medical税。
还能要回来么?大家有成功的经验么?
avatar
a*o
4
好多看不到,而且一点击,就没了. 华人上有个说下载解码软件,但是我下了,但是好象是
个假的呀,动不动就是个别的什么公司.我都担心病毒.
有什么解法呀?
不习惯pplive.
avatar
b*e
5
【 以下文字转载自 Joke 讨论区 】
发信人: yoh (海豚), 信区: Joke
标 题: 企鹅的智商真让人捉急
发信站: BBS 未名空间站 (Tue May 13 10:35:05 2014, 美东)
avatar
l*h
6
the only word I want to say after reading this is "damn."

【在 i*****y 的大作中提到】
: 一年前在此发帖咨询得到一些很好的帮助。非常感谢!现想就一些新情况咨询懂医的网
: 友。
: 我父亲有长期烟史,壮年时得过肺结核。2003年底发现肺右下叶背段病灶,各种测试包
: 括同位素都无法确诊。2004年6月在胸腔镜辅助下手术,取样确定为癌症,改行右肺中
: 下页切除术,诊断是“原发性支气管肺癌,肺泡细胞癌T2N0M0ⅠB KPS90分”。随后做
: 了几
: 轮化疗。
: 这轮治疗后虽有很小肺部病灶,医生不建议其它治疗,病灶发展缓慢。2007开始一直服
: 用特罗凯似对存在的病灶有抑制作用。2011年5月左右起有骨转移症状,进行针对性放
: 疗似有效。2011年12月出现一些脑转移,全脑放疗几个月后检查似有较好抑制作用。

avatar
s*e
7
你找我报税,我可以帮你要回来。

【在 i**c 的大作中提到】
: f1 2003年来美,07年开始1年的opt,08年10月开始h1.
: 07-08 opt期间,交了一年的ssn和medical税。
: 还能要回来么?大家有成功的经验么?

avatar
s*s
8
pps对海外用户的海外视频全部屏蔽了。。连动画片都不能放了。

【在 a******o 的大作中提到】
: 好多看不到,而且一点击,就没了. 华人上有个说下载解码软件,但是我下了,但是好象是
: 个假的呀,动不动就是个别的什么公司.我都担心病毒.
: 有什么解法呀?
: 不习惯pplive.

avatar
M*N
9
哈哈~无一例外的啊

【在 b********e 的大作中提到】
: 【 以下文字转载自 Joke 讨论区 】
: 发信人: yoh (海豚), 信区: Joke
: 标 题: 企鹅的智商真让人捉急
: 发信站: BBS 未名空间站 (Tue May 13 10:35:05 2014, 美东)

avatar
i*y
10
I would appreciate useful comments/suggestions (and no meaningless comments)
. Thanks for your time, but I am not sure what point you are trying to make
here. I am very proud of and truly respect my father and other cancer
patients who have the courage to face and fight such diseases/ordeals.

【在 l*h 的大作中提到】
: the only word I want to say after reading this is "damn."
avatar
f*k
11
楼上可能是在开玩笑,找他报税报的是个人所得税。
社会保险税从税务局是拿不回来的,因为那笔钱并没有交到税务局。
avatar
o*y
12
人要上市了 正忙着收拾干净。。。
avatar
l*r
13
我一直期待看那个个最高的走。。。

【在 M****N 的大作中提到】
: 哈哈~无一例外的啊
avatar
l*h
14
you should know the so-called CIK was a hot concept in 80s and early 90s. it
was determined there was no merit to go into clinical trials. it is still
studied in labs but no major advance has been made in the last two decades.
it is simply robbery and fraud in using it in patients who really need to
use their money on effective treatments.
Most patients generate resistance in 6m - 1y to Tarceva. You should not have
assumed it was still effective. Testing old specimens doesn't provide any
guidance. Even testing current specimens doesn't necessarily do after
treatment.
Please don't take only flattering words as helpful.

comments)
make

【在 i*****y 的大作中提到】
: I would appreciate useful comments/suggestions (and no meaningless comments)
: . Thanks for your time, but I am not sure what point you are trying to make
: here. I am very proud of and truly respect my father and other cancer
: patients who have the courage to face and fight such diseases/ordeals.

avatar
m*3
15
你可以要你工作的公司帮你去要钱,这样就能很快要回来。
avatar
s*s
16
传PPS将7月赴美IPO募资1亿美元 官方称不回应2011年06月27日 16:39
来源:i美股
字号:T|T0人参与0条评论打印转发6月27日消息,今天中午,有消息人士向众多媒体发
来文章宣称,P2P网络电视服务商PPS(PPStream)将于今年7月初正式赴美IPO。其主承
销商为美国银行美林及瑞银两家,此次IPO将募资金额为1亿美金。
该名人士在文中表示,其上市具体时间为美国国庆(7月4日)后。不过,目前,PPS尚
未向美国证监会提交IPO申请和招股说明书。一般而言,提交申请后才会路演,并公布
发行股价区间,而路演时间一般会需要费15-20天。
照此推断,上述消息人士说的7月初赴美上市,或指为向美国证监会提交IPO申请。
实际上,早在去年9月,业内已经传出PPS正筹备上市的消息,当时PPS总裁徐伟峰对腾
讯科技证实,PPS确实正筹备上市,并已经具备在国内外市场上市条件。
今年2月份,业内再度传出PPS将于今年上半年赴美上市募资超2亿美元,同样是美国银
行美林和瑞银为其主承销商。
对于今天的再度上市传言,腾讯科技致电徐伟峰和公关部,对方表示此类传言太多,不
予回应。
avatar
a*3
17
可怜见滴。。。

【在 b********e 的大作中提到】
: 【 以下文字转载自 Joke 讨论区 】
: 发信人: yoh (海豚), 信区: Joke
: 标 题: 企鹅的智商真让人捉急
: 发信站: BBS 未名空间站 (Tue May 13 10:35:05 2014, 美东)

avatar
l*h
18
you should also understand growth factor inhibition has double effects in
reducing tumor size and but in certain cases promotes invasiveness and
metastasis. this is especially obvious in VEGF inhibition, but also present
in inhibiting other growth factors that have effects in angiogenesis. so
once you see metastasis, you should seriously think about whether you should
continue your current regimen.

comments)
make

【在 i*****y 的大作中提到】
: I would appreciate useful comments/suggestions (and no meaningless comments)
: . Thanks for your time, but I am not sure what point you are trying to make
: here. I am very proud of and truly respect my father and other cancer
: patients who have the courage to face and fight such diseases/ordeals.

avatar
S*P
19
要回来过,不过等了将近一年的时间
avatar
s*s
20
这货要1亿?
还美金?
真以为地球人傻钱多啊
avatar
k*z
21
个高的腿也不高。。

【在 l****r 的大作中提到】
: 我一直期待看那个个最高的走。。。
avatar
I*a
22
I would suggest to continue Tarceva and Zometa and if your father has only
localized bone metastasis. If the new scan shows more progressive findings,
I would suggest to add Alimta in addition. Alimta is a fairly benign
chemotherapy and the side effects are minimal. If that fails I would then
consider Avastin combination. At any time, he could try Afatinib (an
more potent form of Tarceva) if it is available. This drug likely will be
approved in US by the end of this year.
I am against what so called DC-CIK therapy.
Good luck.
avatar
Z*I
23
一样是IRS退的

【在 f******k 的大作中提到】
: 楼上可能是在开玩笑,找他报税报的是个人所得税。
: 社会保险税从税务局是拿不回来的,因为那笔钱并没有交到税务局。

avatar
l*d
24
都收拾干净,谁还看啊。

【在 s***s 的大作中提到】
: 传PPS将7月赴美IPO募资1亿美元 官方称不回应2011年06月27日 16:39
: 来源:i美股
: 字号:T|T0人参与0条评论打印转发6月27日消息,今天中午,有消息人士向众多媒体发
: 来文章宣称,P2P网络电视服务商PPS(PPStream)将于今年7月初正式赴美IPO。其主承
: 销商为美国银行美林及瑞银两家,此次IPO将募资金额为1亿美金。
: 该名人士在文中表示,其上市具体时间为美国国庆(7月4日)后。不过,目前,PPS尚
: 未向美国证监会提交IPO申请和招股说明书。一般而言,提交申请后才会路演,并公布
: 发行股价区间,而路演时间一般会需要费15-20天。
: 照此推断,上述消息人士说的7月初赴美上市,或指为向美国证监会提交IPO申请。
: 实际上,早在去年9月,业内已经传出PPS正筹备上市的消息,当时PPS总裁徐伟峰对腾

avatar
x*g
25
水边那是啥?看着很奇怪。。。

【在 b********e 的大作中提到】
: 【 以下文字转载自 Joke 讨论区 】
: 发信人: yoh (海豚), 信区: Joke
: 标 题: 企鹅的智商真让人捉急
: 发信站: BBS 未名空间站 (Tue May 13 10:35:05 2014, 美东)

avatar
i*y
26
Thanks for the suggestions! I looked at Afatinib clinical trials. A few
ongoing trails do include Chinese sites, although the recruitment has not
started yet. Will need to read their eligibility criteria more carefully and
follow up. Thanks!

,

【在 I****a 的大作中提到】
: I would suggest to continue Tarceva and Zometa and if your father has only
: localized bone metastasis. If the new scan shows more progressive findings,
: I would suggest to add Alimta in addition. Alimta is a fairly benign
: chemotherapy and the side effects are minimal. If that fails I would then
: consider Avastin combination. At any time, he could try Afatinib (an
: more potent form of Tarceva) if it is available. This drug likely will be
: approved in US by the end of this year.
: I am against what so called DC-CIK therapy.
: Good luck.

avatar
s*l
27
ppstream已经完蛋了
想重新安装, 但是根本就下载不下来.
现在用PPTV
avatar
l*h
28
apparently your dad has metastasis to multiple organs/sites. there are two
options:
1. go aggressive with conventional chemo regimens
2. change to mainly palliative care
to be honest, waiting for a "new" drug is not a viable option. inclusion of
such patients usually occurs quite some time after the drug is approved in
the specific jurisdiction. the abuse of "new" drugs in China is just
astounding.

and

【在 i*****y 的大作中提到】
: Thanks for the suggestions! I looked at Afatinib clinical trials. A few
: ongoing trails do include Chinese sites, although the recruitment has not
: started yet. Will need to read their eligibility criteria more carefully and
: follow up. Thanks!
:
: ,

avatar
a*o
29
re

【在 s***s 的大作中提到】
: 这货要1亿?
: 还美金?
: 真以为地球人傻钱多啊

avatar
l*h
30
to be more specific, at this time, if you don't want to go the palliative
path, you should urge your dad's oncologist to consider the following
regimens:
1. a microtubule inhibitor + a platinum derivative or
2. a microtubule inhibitor + a platinum derivative + a conventional
alkylating agent
folate antimetabolites can also be considered but I would not place them
ahead of the above two options.
you should be very cautious to consider bevacizumab. remember, your dad is ~
65 yo. bevacizumab just causes a lot of problems in this age group and doesn
't show actual clinical benefits. you should also remember your dad has
already intracranial metastasis.
it is easy for other people to give you some recommendations to use some
regimens on some high profile clinical trials. but your dad obviously doesn'
t fit into any of those groups that showed clinical benefits.

of

【在 l*h 的大作中提到】
: apparently your dad has metastasis to multiple organs/sites. there are two
: options:
: 1. go aggressive with conventional chemo regimens
: 2. change to mainly palliative care
: to be honest, waiting for a "new" drug is not a viable option. inclusion of
: such patients usually occurs quite some time after the drug is approved in
: the specific jurisdiction. the abuse of "new" drugs in China is just
: astounding.
:
: and

avatar
B*1
31
我也发现在PPS上好多一点击就不见了,然后我就把点击的节目名放在搜索里,搜索完
还是没有,但出现了一个到网页上搜索,点那个,就到了PPS的网站上,发现我要找的
节目都在,可以在它的网站上播放。

【在 a******o 的大作中提到】
: 好多看不到,而且一点击,就没了. 华人上有个说下载解码软件,但是我下了,但是好象是
: 个假的呀,动不动就是个别的什么公司.我都担心病毒.
: 有什么解法呀?
: 不习惯pplive.

avatar
I*a
32
Some of the unique points of this particular lung cancer are:
1. It is EGFR mutation positive now likely has gained the resistance
mechanism.
2. The majority of the metastasis are in brain (not surprising) and bones.
So following cookie cutting algorithm may not be the optimal way to go.
There is nothing wrong to give him platinum doublet although I favor Alimta
in the doublet given the result from PARAMOUNT data and it is probably more
reasonable in my opinion to start with 1 agent given his progressive disease
is only in the bones. Afatinib in combination with Cetuximab in small phase
2 study produced almost 100% disease control rate and 50% response rate in
61 patients who accquired resistance after Tarceva or Irissa so I strongly
urge him to get enrolled in similar clinical trial if it is available.
I do
not recall ECOG4599 trial had the breakdown of response rate for EGFR
mutation status but I would not withhold Avastin base on his age or the
brain
metastasis. Those are not contraindications. I forgot to mention another
alternative which is to target c-met. The drug I am aware of is ARQ 197
however the phase 3 trial has been closed to recruiting.

~
doesn

【在 l*h 的大作中提到】
: to be more specific, at this time, if you don't want to go the palliative
: path, you should urge your dad's oncologist to consider the following
: regimens:
: 1. a microtubule inhibitor + a platinum derivative or
: 2. a microtubule inhibitor + a platinum derivative + a conventional
: alkylating agent
: folate antimetabolites can also be considered but I would not place them
: ahead of the above two options.
: you should be very cautious to consider bevacizumab. remember, your dad is ~
: 65 yo. bevacizumab just causes a lot of problems in this age group and doesn

avatar
w*i
33
免费注册那个用户好像可以解决问题
另外英文版下面有乱码,要找个外挂的软件处理一下
avatar
i*y
34
Hello icetea, lmh, & others who emailed me with useful information,
Thanks to you all for spending your time to offer valuable inputs. I will
take those into considerations and talk to my father's oncologist.
Another question: if there are appropriate medications that are available in
U.S. but not in China, is there any way for my father to purchase them from
U.S.? Meanwhile, If his new scan ( in a month) shows further metastasis (
hope not!), we will also consider the chemo option(s).
Thanks,
avatar
l*h
35
In principle, I agree with you on the use of pathway inhibitors. I think I
disagree with you on the practical issues.
1. her dad's oncologist doesn't seem to have a good knowledge of the
mutations of the tumor, the complexity of the pathways and the mechanisms of
these inhibitors.
2. his intracranial metastasis is a real big concern. if you think those
more conventional drugs are bad in getting into the brain (and the tumor),
currently available TKIs are worse. certain chemo drugs have been shown to
be somewhat effective for brain lesions including some of the -platins. so
far all the tested TKIs are disappointing for brain lesions even though they
may be highly effective for extracranial lesions.
3. avastin is not effective for brain lesions given by iv. we ask our
interventional neuroradiology people to give avastin to gbm and brain
metastasis patient using selective intraarterial injection preceded by
mannitol. this must be under a clinical trial protocol, or under a
regulatory approval based on compassionate grounds if the patient doesn't
qualify under the study protocol.
4. TKIs in principle can also be delivered by selective intraarterial
injection. the practical issue is they are only clinically available as
tablets or capsules. pharmaceutical companies have injections for
pharmacological studies. it wouldn't be easy to persuade them to give you
some. then you will also need some expertise from yourself or help from
clinical pharmacologists to scale the dose for IA injection.
5. if the number of metastatic sites are very small, convection-enhanced
delivery can be an effective way to deliver the drugs. then you will need a
neurosurgeon good at stereotactic targeting to do the procedure.
6. if the number of metastatic sites are very small, I would also suggest to
consider conformal radiation therapy to the metastatic sites to regular
dose, and involved field radiation to the whole brain at a lowered dose (~ 1
/3 – 1/2 of the metatstatic site dose). actually i would suggest this over
points 3, 4 and 5 because if the equipment is available, this is the easiest
to do.
7. other ways of blood-brain barrier opening/disruption have not shown any
improvement in brain cancer (primary or metastatic) therapy so far.
8. if all the therapeutic agents and technical expertise are available, the
lax regulation in China definitely can be played to his favor.

Alimta
more
disease
phase
in

【在 I****a 的大作中提到】
: Some of the unique points of this particular lung cancer are:
: 1. It is EGFR mutation positive now likely has gained the resistance
: mechanism.
: 2. The majority of the metastasis are in brain (not surprising) and bones.
: So following cookie cutting algorithm may not be the optimal way to go.
: There is nothing wrong to give him platinum doublet although I favor Alimta
: in the doublet given the result from PARAMOUNT data and it is probably more
: reasonable in my opinion to start with 1 agent given his progressive disease
: is only in the bones. Afatinib in combination with Cetuximab in small phase
: 2 study produced almost 100% disease control rate and 50% response rate in

avatar
l*h
36
I think there is some laws allowing pharmaceutical companies to give out
some drugs to foreign patients if you can provide documents that the drug is
essential for treatment and will be handled by qualified foreign physicians
. You will need to plead with those companies directly. You can prepare a
medical summary and have it translated and notarized in advance.
Another question: if there are appropriate medications that are available in
U.S. but not in China, is there any way for my father to purchase them from
U.S.?

in
from

【在 i*****y 的大作中提到】
: Hello icetea, lmh, & others who emailed me with useful information,
: Thanks to you all for spending your time to offer valuable inputs. I will
: take those into considerations and talk to my father's oncologist.
: Another question: if there are appropriate medications that are available in
: U.S. but not in China, is there any way for my father to purchase them from
: U.S.? Meanwhile, If his new scan ( in a month) shows further metastasis (
: hope not!), we will also consider the chemo option(s).
: Thanks,

相关阅读
logo
联系我们隐私协议©2024 redian.news
Redian新闻
Redian.news刊载任何文章,不代表同意其说法或描述,仅为提供更多信息,也不构成任何建议。文章信息的合法性及真实性由其作者负责,与Redian.news及其运营公司无关。欢迎投稿,如发现稿件侵权,或作者不愿在本网发表文章,请版权拥有者通知本网处理。