1.Which lung cancer patients are suitable for treatment with ERSA?
ERSA is mainly used to treat locally advanced or metastatic non-small cell lung cancer that has previously received or is not suitable for chemotherapy and radiotherapy.
2.Under what conditions is ERSA effective in the treatment of lung cancer?
The results of current clinical studies show that ERSA is more effective in patients of Eastern ethnicity (predominantly Asian), women, non-smokers, and patients with alveolar cell carcinoma or adenocarcinoma. However, the main factor is not the type of lung cancer and the physical characteristics of the patient, but the type of lung cancer (predominantly Asian, female, non-smoker).
3. Is ERSA effective for patients with lung squamous carcinoma or other non-small cell lung cancers if it is highly effective for adenocarcinoma?
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 condition.
4. The preliminary results of an international multicenter clinical trial (ISEL) on ERSA in the United States at the end of last year showed that ERSA did not prolong the survival of lung cancer patients, but why was ERSA still officially marketed in China?
According to information provided by AstraZeneca, the results of this trial showed that it did not extend overall patient life, but the trial also found that ERSA extended the survival of participating Eastern populations by more than 8 months or longer, with the longest patient currently surviving for 5 years and still in good health. Overall survival and remission rates in the Eastern population were significantly better than in the Western population. This result reaffirms previous clinical studies suggesting that the efficacy of ERSA treatment is uniquely superior in patients of Eastern ethnicity. In clinical trials conducted in China, ERSA achieved an efficacy rate of 50%-80% or more for advanced non-small cell lung cancer, with a clinical benefit rate of 80% or more. These trial results provide clinical support data for the marketing approval of ERSA in China.
5.When to choose ERSA treatment and when to choose chemotherapy?
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. We have treated patients who are determined not to take chemotherapy, but after taking ERSA, the tumor shrinks to partial remission or complete remission (complete remission), but after 1 year of ERSA treatment, drug resistance appears and the tumor progresses, and the patient is mobilized again to take systemic chemotherapy, but it is still apparently effective.
6.When does ERSA take effect and when do I stop using it?
Generally, it starts to take effect in about 1 to 2 weeks after oral administration, so the efficacy can be evaluated initially after 1 month of administration. If it is effective, it should be continued for a long time until the tumor progresses and then be considered for discontinuation or adjustment.
7.Can I reduce the dosage after the effective treatment of Erythromycin?
A: It should be very cautious to reduce or stop the dosage after effective treatment. We treated a patient who achieved complete tumor regression after treatment with ERSA. After discontinuing the drug for economic reasons, the tumor recurred again and the tumor regressed completely again with ERSA treatment. However, there are also cases where discontinuation and then reintroduction is not effective.
8.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 skin rash, other side effects include impaired liver function, nausea and vomiting, but most of them are mild and can be relieved after symptomatic treatment. In addition, interstitial pneumonia occurs in a very small number of patients and requires immediate hospitalization. Patients are recommended to be hospitalized in oncology specialty for observation in the early stage of drug administration, 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 interstitial pneumonia caused by ERSA scary?
The average incidence of interstitial pneumonia caused by ERSA is about 1% worldwide, and the incidence in China is even lower, at 0.5%. Fatal cases have occurred occasionally 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 number of patients with advanced lung cancer who have other lung diseases (tuberculosis, emphysema, bronchial asthma, etc.), the lungs are prone to induce infections, so it is not entirely certain that all interstitial pneumonia is due to ERSA.
10.The prospect of molecular targeted therapy for lung cancer?
In recent years, the successive release of new molecular targeted therapies has changed the traditional therapeutic thinking and model, bringing new hope to patients and their families with advanced lung cancer. The combination of molecular targeted drugs and traditional therapies or the combination of different molecular targeted drugs is the future development direction.