1.Q: Which lung cancer patients are suitable for treatment with ERSA?
A: ERSA is mainly used for the treatment of locally advanced or metastatic non-small cell lung cancer that has received prior chemotherapy.
2.Q: Under what conditions is ERSA effective in the treatment of lung cancer?
A: The results of current clinical studies show that the efficacy of ERSA is more definite in patients with oriental race (mainly Asian), female, non-smokers, alveolar cell carcinoma or adenocarcinoma. Timely administration or not will also affect the treatment effect.
3.Q: Is ERSA effective for patients with squamous lung cancer or other non-small cell lung cancers because of its high efficacy in adenocarcinoma?
A: The efficacy of ERSA for squamous lung cancer is lower than that for adenocarcinoma and alveolar lung cancer. However, some patients with squamous lung cancer and other non-small cell lung cancer can still observe significant efficacy after taking ERSA according to their actual situation.
4.Q: Under what circumstances should I choose ERSA treatment and under what circumstances should I choose chemotherapy?
A: This is a question that often confuses patients. The results of the current study show no significant difference in efficiency between concurrent use of the two and monotherapy, so concurrent use is not advocated. ERSA is now approved as a second-line treatment for lung cancer, mainly for advanced lung cancer after chemotherapy has failed, but it can also be used as a first-line drug in some patients who are determined not to receive chemotherapy or have contraindications to chemotherapy. However, the general recommendation is to consider chemotherapy first before considering ERSA treatment. After failure of ERSA treatment, systemic chemotherapy can still be considered if the patient has not received previous chemotherapy and is in good health. Some patients who are determined not to undergo chemotherapy can also shrink their tumors to achieve partial remission or complete remission (complete remission) after taking ERSA, but after 8 months of ERSA treatment, drug resistance may occur and the tumor may progress, at this time, the patient can be mobilized again for systemic chemotherapy and still achieve significant results.
5.Q: When does ERSA take effect and when do I stop using it?
The most direct way is to observe the change of tumor through re-CT examination. If the tumor does not grow significantly compared with that before taking the drug, it means that the drug effect has been exerted, if there is effect, continue to take it for a long time until the tumor progresses again (i.e. drug resistance) and then consider stopping or adjusting.
6.How to determine whether Erythromycin is effective?
A: Whether it is effective or not mainly depends on two aspects. One is the improvement of the patient’s physical symptoms, such as pain reduction, cough reduction, lymphatic shrinkage, mental improvement, etc. The second is the imaging report (CT), which is a comparative examination that can be done for the primary and metastatic foci after taking it for a period of time. If it is effective, the reaction on the film is very obvious, and the tumor no longer continues to grow significantly or gradually becomes smaller.
It should be emphasized that: whether side effects such as rash, scratching and diarrhea appear and the degree of their appearance are not criteria for the effectiveness of Erythromycin, but only for reference. Because the appearance of side effects also varies from person to person and is not absolute.
7.Q: Can I reduce the dosage after the effective treatment of ERSA with financial difficulties?
A: Dose reduction or discontinuation after effective treatment should be done with great caution. Individual patients who have achieved complete tumor regression after ERSA treatment have had their tumors recur for economic reasons or other reasons after discontinuing the drug, thus requiring re-initiation of ERSA treatment, but there are also cases where discontinuation and then re-taking is not effective.
8.Q: What are the side effects of ERSA and can I take the drug at home?
A: The most common side effects of ERSA are diarrhea and rash, and others include impaired liver function, nausea and vomiting, but most are mild and can be relieved with symptomatic treatment. Side effects are usually only likely to occur at the beginning of the course of the drug and will gradually resolve as the drug continues to be taken for a longer period of time. In addition, interstitial pneumonia may occur in a very small number of patients taking ERSA, requiring immediate hospitalization. Patients are recommended to be hospitalized in oncology specialty for observation in the early stage of taking the drug, and can return home to take the drug after the condition is stabilized, but they should still follow up with the hospital regularly.
9.Is it normal for patients not to experience side effects after taking Erythroxa? Is it a fake drug if there are no side effects?
A: The absence of side effects after taking ERSA is also normal and does not necessarily mean that it is a counterfeit drug. The patient’s reaction to the drug and the absorption effect varies from person to person, in addition to allopathic, with the characteristics of the patient’s degree of illness, physical function conditions, the choice of the timing of taking the drug have a lot to do with a variety of factors, so whether or not side effects and diarrhea, rash and other side effects of the degree of size are not certain, some patients take after the side effects are obvious, and even cause interstitial pneumonia, while some patients take the drug after the side effects are not obvious. side effects are not obvious, are normal.
Friendly reminder: now some patients are misled to think that after taking no side effects of ERSA is fake, this view is one-sided, the active ingredient content is very low counterfeit ERSA after taking is certainly not obvious side effects, but it does not say that no side effects of ERSA must be fake.
10.Q: Is the interstitial pneumonia caused by ERSA terrible?
A: The global average incidence of interstitial pneumonia due to ERSA is about 1%, and the incidence in China is even lower, only 0.5%. Fatal cases have occasionally occurred in Japan, but have not been reported in China to date. We advocate that ERSA should be used with caution in individual patients with existing pulmonary fibrosis, extensive radiotherapy, and severely impaired lung function to prevent the development of fatal interstitial pneumonia. However, in a significant proportion of patients with advanced lung cancer who themselves have other lung diseases (tuberculosis, emphysema, bronchial asthma, etc.), the lungs are susceptible to induced infections, so it is not entirely certain that all interstitial pneumonia is due to ERSA.
11.Q: How to take ERSA and when to choose?
A: The recommended oral dose of ERSA and Trocaire is 1 tablet, once a day, on an empty stomach or semi-empty stomach.
(1) If the patient has a good gastrointestinal tract, it is recommended to take it on an empty or semi-empty stomach, which will be beneficial for the absorption of the drug. (1) If the patient has a good gastrointestinal tract, it is recommended to take the drug on an empty stomach or semi-empty stomach, which is good for the absorption of the drug.
(2) If the patient’s gastrointestinal tract is not good, it is recommended to take it between half an hour and one hour after meals. It is better not to eat strong alkaline food before and after taking the drug, and it is not good to drink strong tea, but generally the effect will not be great, and you do not need to worry too much.
ERSA (gefitinib tablets) does not require dose adjustment for the following conditions: age, weight, gender, race, renal function, moderate to severe hepatic impairment due to liver metastases. Dose adjustment: When a patient experiences an intolerable adverse reaction, this may be addressed by a short-term suspension of therapy, after which the dose of one tablet (250 mg) per day should be resumed.
In patients with swallowing difficulties, the tablet may be dispersed in half a glass of drinking water (non-carbonated beverage), but no other liquid should be used. Drop the tablet into the water without crushing it, stir until it is completely dispersed (about 10 minutes), and drink the solution immediately. Rinse the glass with another half cup of water and drink. The solution can also be given through a nasogastric tube.
ERSA can be taken with other herbal and western medicines. However, in order to exclude interactions with other medicines, please develop a dosing schedule that staggers the dosing time of ERSA (Gefitinib tablets) with other medicines to ensure that ERSA is taken independently.
12.Q: Can I take ERSA with Chinese medicine?
A: Both ERSA and Tricor can be taken together with Chinese medicine. The specific Chinese medicine prescription cannot be generalized, but should be prescribed by a professional Chinese medicine doctor according to the patient’s specific conditions after on-site diagnosis, and it is best to obtain the consent of the attending doctor before using the medicine.
13.How much is the selling price of ERSA in India reasonable in China?
A: The retail price of ERSA in Indian pharmacies was originally 10,200 rupees, but later adjusted to 10,353 rupees (printed on the side of the drug box), which is equivalent to about 1,500 yuan, only the whole box purchase pharmacies will give a certain discount, but finally brought back to the domestic ERSA plus transportation costs and the necessary labor overhead its actual cost is close to the retail price in India. The offer on the domestic market varies from high to low, which accounts for a relatively high 1800 yuan —-2600 yuan/box of domestic retail price is the most real and reasonable, and the price of the take profit is mainly dependent on the volume. Therefore, the current market where below the Indian retail price of the sale of ERSA are generally unreliable. At present, there are fake ERSA manufactured by domestic counterfeiters on our market, and counterfeit ERSA is mainly to attract patients with low prices, so please be careful to buy, do not be overly greedy for cheap, be careful to buy fake drugs!
14.What is the difference between ERSA and Tricor, which are both targeted drugs for non-small cell lung cancer? How should they be used in clinical practice?
A: Both ERSA and Trocet are the most widely used molecularly targeted drugs for non-small cell lung cancer with the most clinically proven efficacy. They are both small molecule compounds with similar efficacy, which is why some doctors call them “sister drugs”. However, strictly speaking, there are differences between them. In terms of price, the price of Tricor is much higher than that of ERSA. The domestic retail price of ERSA in India is 1800 yuan —-2600 yuan/box, while the domestic retail price of Tricor is 4600 yuan/box; in terms of efficacy, the efficacy of Tricor is stronger than that of ERSA, and the chance of side effects is higher accordingly. In clinical practice, patients are usually advised to use Erythroxa first, and then switch to Troche after the patient has developed resistance to Erythroxa, which is conducive to the continuation and depth of treatment. In the clinic, after the resistance to ERSA and then take Trocaire can generally see more obvious efficacy, but it is not absolute, depending on the individual, there are individual patients failed to see obvious efficacy or shorter period of effect; from the specifications, the Indian version of ERSA and Trocaire are 30 tablets/box, patients take one tablet per day, a box is a month’s dose, the difference is that ERSA is 250mg/tablet, while In terms of properties, the Indian version of ERSA has a reddish-brown surface, and the two sides of the tablet are printed with the indentations “250” and “GEFTINAT” respectively. The surface of the tablets of Trokai is white, and there is no wording (this is a question that many patients have asked me).
15.Since Indian EfTINAT is a generic drug, isn’t it a fake drug?
A: Many people will hear the word “generic” associated with counterfeit, which is one-sided, India ERSA is indeed a copy of the British ERSA, from the point of view of intellectual property rights, the Indian version of ERSA does not have international legal protection, but from the actual drug composition and efficacy is excellent quality. As a British colony for many years, India’s generic version of ERSA by NATCO, the second largest pharmaceutical group in the country, is almost identical to that of AstraZeneca in terms of composition and production process, and the control of excipients, time, temperature, pH and bioavailability in the production process is also the same. The clinical application shows that the efficacy of Indian ERSA is basically the same as that of British ERSA. Taking Indian ERSA can effectively control the growth and spread of cancer cells, and for patients with good absorption effect, it can make the tumor shrink and achieve the purpose of controlling the disease for a long time. Thus, the Indian version of ERSA is not strictly speaking a fake drug, and its quality is very reliable.
16.How does the active ingredient of Indian ERSA compare with British ERSA?
A: After chromatographic analysis and comparison by authoritative institutions, the active ingredients of Indian ERSA can account for 93%-95% of British ERSA. Patients can also go to drug testing laboratories or large medical institutions for testing and verification if they have the conditions after getting the drug. In order to ensure that the scientific and formal testing route to detect the active ingredients of genuine Indian ERSA will not produce too much deviation.
17.How can I tell if a patient has developed drug resistance to Erythroxa? How long does it take to develop resistance to ERSA?
A: The growth and spread of cancer cells will be controlled and relieved after ERSA starts to take effect, and the tumor of the lesion will not continue to grow significantly and gradually appear to shrink. However, if the disease suddenly recurs after a period of time, i.e. the tumor starts to grow again or new metastasis occurs, it can be judged that drug resistance has occurred, because the emergence of drug resistance means that the drug has lost its effect on the patient.
Theoretically, resistance to Erythromycin may appear after 6-8 months of taking the drug, but it varies from person to person. The longest period of time that we have been in contact with is two years and six months of taking Erythroxa and still no resistance has been developed. So it is said that the early and late emergence of drug resistance is closely related to the patient’s own body function and the characteristics of the disease.
18.What should patients do after taking ERSA to develop drug resistance?
A: Once a patient develops drug resistance to ERSA, it means that ERSA has lost its efficacy to the patient, mainly manifested by recurrence of the disease, reappearance of tumor growth or new spread of metastasis. There are two treatment options commonly used in clinical practice after the development of ERSA resistance.
(1) switching to the more potent troche. It can be used as a follow-up drug to ERSA, but the efficacy varies from person to person. There is no accurate conclusion on how long Tricor Kay can be maintained, which is usually a few months.
(2) If the patient’s physical condition allows, he or she can consider chemotherapy after seeking the doctor’s advice, which can usually be effective and bring the disease back under control.
Note: Many patients have asked me if it would be effective to take Erythroxa again after changing to Troche or after chemotherapy has failed again. The answer to this should be basically yes, after the loss of effectiveness of Troche and chemotherapy again, then there is little point in taking ERSA again.
19.In addition to non-small cell lung cancer, what other types of cancers are treated with ERSA and Tricor?
A: ERSA and Tricor are targeted drugs mainly for non-small cell lung cancer. In addition, it has been clinically proven that they also have anti-tumor activity against breast cancer, rectal cancer, prostate cancer, lymphoma, stomach cancer, intestinal cancer and other solid tumors, and some patients can also achieve good results after taking them.
20.What is the prospect of targeted therapy?
A: In recent years, the successive listing of new molecular targeted therapies has changed the traditional therapeutic thinking and mode, bringing new hope to advanced lung cancer patients and their families. The combination of molecular targeted drugs and traditional therapies, or the combination of different molecular targeted drugs is a trend in the future.
21.What do lung cancer patients need to pay attention to in their diet?
A: The digestive system of early to mid-stage lung cancer patients is sound. After clinical diagnosis, they should seize the time to supplement the body with nutrients to improve physical quality, enhance resistance and prevent or delay the emergence of cachexia. Patients with adequate nutrient supplementation and better body condition before clinical treatment are more tolerant to chemotherapy and radiotherapy and have better treatment effect. Similarly, patients in better condition are more favorable to receive surgery and recover faster than those in poorer nutritional condition. Therefore, early and mid-stage lung cancer patients should be supplemented with various nutrients, such as high-quality protein, carbohydrates, fat, inorganic salts and multivitamins, as soon as their digestive and absorption capacity allows. For lung cancer patients coughing and coughing blood, there are many remedies and food recipes in Chinese medicine to nourish Yin and moisten lung and stop coughing and bleeding, for example, food with function of nourishing Yin and moistening lung such as almond jellyfish, lily, water chestnut, etc., while lotus root, lotus seed, persimmon, duck pear, yam, lily and white fungus also have the function of stopping cough and astringent and stopping bleeding. According to the folk recipes, lung cancer patients can also eat mealybug, turtle paste, turtle meat, glutinous rice and other nourishing and tonic foods.
In addition to the above-mentioned nourishing foods of traditional Chinese medicine, milk, eggs, lean meat, animal liver, soybean products, fresh vegetables and fruits are also suitable for the diet of patients with advanced lung cancer. The amount and frequency of food intake can be increased as much as possible.