索拉非尼(sorafenib)(商品名:多吉美(tosylate))为德国拜耳先灵公司生产的一种口服多激酶抑制剂,可抑制肿瘤的细胞增殖和血管生成.继成功治疗晚期肾癌和肝癌后,该药物在晚期甲状腺癌(不摄碘的甲状腺癌转移扩散扩散灶)的治疗上取得了新的突破.2008年临床肿瘤杂志(Journal of clinical oncology)发表了大样本临床研究成果,具体细节如下:上海市第六人民医院核医学科陈立波
本文作者陈立波，上海市第六人民医院核医学科副主任医师，留德医学博士，上海市青年科技启明星，日本横滨大学客座研究员。在甲状腺疾病的诊治上具有独特的见解和丰富的经验，尤以分化型甲癌（病理为 状或滤泡状甲状腺癌)伴或不伴淋巴结、肺、骨等器官转移扩散扩散的诊治见长。近来在国内率先对难治性（碘-131无效或不摄取））甲状腺癌的分子靶向治疗上进行了有益的尝试，取得了重大的突破并积累了较为丰富的临床经验。 专家门诊时间:周二上午和周四下午；特需门诊时间：周四上午。
Phase II trial of sorafenib in advanced thyroid cancer
Gupta-Abramson V, Troxel AB, Nellore A, Puttaswamy K, Redlinger M, Ransone K, Mandel SJ, Flaherty KT, Loevner LA, O\\\\\"Dwyer PJ, Brose MS.
Developmental TherapeuticsProgram of the Abramson CancerCenter, University of Pennsylvania,Philadelphia, PA 19104, USA.
PURPOSE: Given the molecular pathophysiology of thyroid cancer and the spectrum of kinases inhibited by sorafenib, including Raf kinase, vascular endothelial growth factor receptors, platelet-derived growth factor receptor, and RET tyrosine kinases, we conducted an open-label phase II trial to determine the efficacy of sorafenib in patients with advanced thyroid carcino . PATIENTS AND METHODS: Eligible patients with metastatic, iodine-refractory thyroid carcino received sorafenib 400 mg orally twice daily. Responses were measured radiographically every 2 to 3 months. The study end points included response rate, progression-free survival (PFS), and best response by Response Evaluation Criteria in Solid Tumors. RESULTS: Thirty patients were entered onto the study and treated for a minimum of 16 weeks. Seven patients (23%; 95% CI, 0.10 to 0.42) had a partial response lasting 18+ to 84 weeks. Sixteen patients (53%; 95% CI, 0.34 to 0.72) had stable disease lasting 14 to 89+ weeks. Seventeen (95%) of 19 patients for whom serial thyroglobulin levels were available showed a rked and rapid response in thyroglobulin levels with a mean decrease of 70%. The median PFS was 79 weeks. Toxicity was consistent with other sorafenib trials, although a single patient d of liver failure that was likely treatment related. CONCLUSION: Sorafenib has clinically relevant antitumor activity in patients with metastatic, iodine-refractory thyroid carcino , with an overall clinical benefit rate (partial response + stable disease) of 77%, median PFS of 79 weeks, and an overall acceptable safety profile. These results represent a significant advance over chemotherapy in both response rate and PFS and support further investigation of this agent in these patients.药道网—药到病除，助力生命。汇聚全球药品资讯：多吉美主要抑制那个靶点
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