, i! x/ X. D! H% U% [“The basic idea is to take patient whose cancer has grown on tarceva, do cyberknife to the spots that have grown to eliminate the resistant clones, then continue using tarceva for the rest of the cancer that has shown evidence for ongoing sensitivity to tarceva.”; c; L; ~0 X8 _# b! I
基本理念就是特耐药后，要看是如何耐药的，如果一些肿瘤没变化，只有个别肿瘤长大，说明特是有效的；这种情况耐药，就用射波刀来处理在服特（或其它靶向药）期间长大的肿瘤，然后继续使用特来对付那些显示敏感的肿瘤细胞。: _8 F4 n5 b3 c f+ A2 G0 n o
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“When cancer grows through chemotherapy, it often grows in multiple spots and generates new spots. In contrast, when EGFR-mutated lung cancer grows through tarceva, a good portion of the time it only grows in one or two spots. Recent breakthroughs have shown some of the mechanisms of this resistance.”" _) g* o. ~/ I f9 L
化疗后若肿瘤继续进展，通常是多处增大并有新的转移；相反，如果用特期间基因突变的肿瘤在进展，往往仅限于一处或两处，最新的突破性研究显示了这些耐药机制。 2 @# ?, a% W& C& W q) i( B9 D, m% x+ ^“The key point that I want to make is that progression is often limited. Often, most of the cancer cells remain sensitive to tarceva while one or two spots acquire some change (with “some change” partially defined in the figure above and in Dr. Sequists’s webinar). In theory, if you could eliminate those few spots of resistance, you can imagine that the remainder of the cancer in the body might be well controlled back on tarceva. That’s the core idea here.” / c0 W% O. Z/ W# g. Y- t* C我想表达的一个重点是：耐药的进展是有限的。通常大部分的肿瘤细胞对特还是敏感的，只有一小部分没有控制到。理论上，如果你能有效地消灭一小部分有耐药的肿瘤细胞，我们可以想象特完全有能力控制其余的肿瘤细胞。这就是本文讨论的要点！ # e2 h, _+ W/ l# g5 J- E
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