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Hasil Pencarian

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Jamaluddin M
Efikasi dan toksisiti erlotinib/gefitinib sebagai terapi lini kedua pada pasien kanker paru jenis karsinoma bukan sel kecil = Efficacy and toxicity erlotinib/gefitinib as second line therapi in non small cell lung cancer patients
"ABSTRAK
Tesis ini menilai efikasi dan toksisiti Erlotinib/Gefitinib sebagai terapi lini kedua
pada pasien KPKBSK yang mengalami progresifitas. Ini adalah sebuah penelitian
kohor retrospektif antara tahun 2009 sampai 2013 dari rekam medis pasien
KPKBSK yang mengalami progresifitas. Respons (subjektif, semisubjektif dan
objektif) dievaluasi setiap bulan. Toksisiti dinilai setiap minggu sejak pemberian
Erlotinib/Gefitinib berdasarkan kriteria WHO. Hasil evaluasi respons objektif,
tidak ada pasien yang memberikan respons komplit. Best overall response rate
dari 31 pasien, 48,8% menetap, 22,6% perburukan,12,9% respons sebagian dan
6,5% tidak dinilai/inevaluable. Pada penilaian respons semisubjektif didapatkan
19.4% peningkatan berat badan, 51,6% penurunan berat badan dan 29,0%
menetap. Waktu tengah tahan hidup mencapai 18 bulan, rerata masa tahan hidup
1 tahunan 80,6% dan masa tahan hidup keseluruhan 6,50%. Data menunjukkan
tidak ada timbul toksisiti hematologi berat (grade ¾) dan data penilaian toksisiti
non hematologi sangat jarang timbul toksisiti berat (grade ¾). Efikasi monoterapi
EGFR-TKI (Erlotinib/Gefitinib) cukup tinggi dengan toksisiti yang ditimbulkan
tidak berat. Dengan demikian Erlotinib/Gefitinib sebagai terapi lini kedua cukup
baik.ABSTRACT This thesis assesses the efficacy and toxicity of Erlotinib/Gefitinib as a second
line therapy in NSCLC patients. This is a retrospective cohort study between 2009
and 2013 from the medical records of patients who experienced progression
NSCLC. Therapeutic response was evaluated every month. Toxicity assessed
every month since giving Erlotinib/Gefitinib according to WHO?s criteria. Results
of objective response evaluation none of the patients complete response. Best
overall response rate of 31 patients with the most stable response are 48.8%. Most
semisubjective response obtained are 51.6% weight loss. The middle survival time
reached 18 month, the mean 1 year survival time are 80.6% and a 6.50% overall
survival. The data showed no hematologic toxicity arise severe (grade ¾) and
non-hematological toxicity very rarely arise severe toxicity. The efficacy of EGFR
TKI monotherapy (Erlotinib/Gefitinib) is high enough with toxicity cause not
severe. Thus Erlotinib/Gefitinib as second-line therapy is quite good. ;This thesis assesses the efficacy and toxicity of Erlotinib/Gefitinib as a second
line therapy in NSCLC patients. This is a retrospective cohort study between 2009
and 2013 from the medical records of patients who experienced progression
NSCLC. Therapeutic response was evaluated every month. Toxicity assessed
every month since giving Erlotinib/Gefitinib according to WHO?s criteria. Results
of objective response evaluation none of the patients complete response. Best
overall response rate of 31 patients with the most stable response are 48.8%. Most
semisubjective response obtained are 51.6% weight loss. The middle survival time
reached 18 month, the mean 1 year survival time are 80.6% and a 6.50% overall
survival. The data showed no hematologic toxicity arise severe (grade ¾) and
non-hematological toxicity very rarely arise severe toxicity. The efficacy of EGFR
TKI monotherapy (Erlotinib/Gefitinib) is high enough with toxicity cause not
severe. Thus Erlotinib/Gefitinib as second-line therapy is quite good. "
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Muhammad Ali Asdar
Efikasi gefitinib dan erlotinib pada pasien adenokarsinoma paru dengan mutasi gen epidermal growth factor receptor di Rumah Sakit Rujukan Respirasi Nasional Persahabatan Jakarta = Efficacy of gefitinib and erlotinib for lung adenocarcinoma with epidermal growth factor receptor mutation in Persahabatan Hospital Jakarta
"Pendahuluan: Tyrosine Kinase Inhibitors (TKIs) sangat efektif terhadap Kanker
Paru jenis Karsinoma Bukan Sel Kecil (KPKBSK) dengan mutasi Epidermal
Growth Factor Receptor (EGFR). Gefitinib dan Erlotinib adalah generasi pertama
EGFR-TKI untuk pengobatan KPKBSK dengan mutasi EGFR. Obat-obat ini telah
tersedia melalui asuransi kesehatan di Indonesia untuk pasien Adenokarsinoma
paru dengan mutasi EGFR. Data mengenai efikasi dan toksisitas EGFR-TKI saat
ini belum tersedia di Indonesia.
Metode: Kami melakukan analisis observasional kohort retrospektif pada pasien
Adenokarsinoma paru dengan mutasi EGFR di RSUP Persahabatan, Jakarta
Indonesia dari Januari 2015 sampai dengan Desember 2017. Kami meninjau
rekam medis 331 pasien dengan diagnosis Adenokarsinoma paru dengan mutasi
EGFR stage lanjut yang diobati dengan EGFR-TKI generasi pertama. Sebanyak
192 subjek yang memenuhi kriteria inklusi.
Hasil: Subjek yang mendapatkan Gefitinib (n=132) dan Erlotinib (n=60). Median
progression free survival (PFS) sebanding antara Gefitinib dan Erlotinib (9,0 dan
7,0 bulan, interval kepercayaan 95% [IK] 0,57-1,07, p=0,126). Median Overall
survival (OS) dan angka tahan hidup 1 tahun masing-masing kelompok adalah
44,5 vs 39,5 bulan (95% IK 0,35-1,29, p=0,670) dan 92% berbanding 92%
(p=0,228). Terdapat toksisitas termasuk diare, paronikia, skin rash dan stomatitis
yang diamati tetapi tidak ada perbedaan yang bermakna pada toksisitas derajat 3
atau 4 antara kedua kelompok (p=0,713).
Kesimpulan: Kedua EGFR-TKIs generasi pertama sebanding dalam PFS dan OS,
meskipun Gefitinib terlihat lebih tinggi, tetapi secara statistik tidak bermakna dan
keduanya memiliki toksisitas yang sebanding dan dapat ditoleransi.
Introductions: Tyrosine kinase inhibitors (TKIs) are effective against non-small
cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR)
mutation. Gefitinib and erlotinib are the first-generation EGFR-TKIs
recommended as first-line treatments for NSCLC with EGFR mutations and are
available through Universal Health Coverage in Indonesia for lung
adenocarcinoma patients with EGFR mutations. However, the efficacy and safety
data of EGFR-TKIs are unavailable in Indonesia.
Methods: We did a retrospective cohort analysis of the patients of lung
adenocarcinoma with EGFR mutations treated in Persahabatan Hospital Jakarta,
Indonesia, between January 2015 and December 2017. We reviewed the records
of 331 patients with advanced stage lung adenocarcinoma with EGFR mutation
treated with the first-generation EGFR-TKIs. The subjects were 192 patients who
met the inclusion criteria.
Results: Subjects were receiving gefitinib (n=132) and erlotinib (n=60). Median
progression-free survival (PFS) was comparable between gefitinib and erlotinib
(9.0 vs 7.0 months, 95% confidence interval [CI] 0.57-1.07, p=0.126). The
median overall survival (OS) and 1-year survival were 44.5 vs 39.5 months
(95%CI 0.35-1.29, p=0.228; and 92% vs 92%, p=0.228, respectively). Reported
toxicities were diarrhea, paronychia, rash, and stomatitis but not of significant
difference between grade 3 or 4 toxicities (p=0.713).
Conclusions: The PFS and OS of the first-generation EGFR-TKIs were
comparable, although gefitinib PFS and OS was shown to be better, but without
significance. Both gefitinib and erlotinib had comparable and tolerable adverse
effects"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2019
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library