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Br J Cancer:FOLFOXIRI和贝伐单抗治疗转移性结直肠癌的临床研究汇总分析

2020-10-17 xiaozeng MedSci原创

FOLFOXIRI(5-氟尿嘧啶、L-亚叶酸、奥沙利铂 oxaliplatin和伊立替康 irinotecan))/贝伐单抗(bevizumab,bev)目前已被证明是转移性结直肠癌(mCRC)患者的

FOLFOXIRI(5-氟尿嘧啶、L-亚叶酸、奥沙利铂 oxaliplatin和伊立替康 irinotecan))/贝伐单抗(bevizumab,bev)目前已被证明是转移性结直肠癌(mCRC)患者的一个有效的一线治疗选择。然而,预先暴露于三种细胞毒性中会引起人们对疾病发展后的治疗效果的担忧。

该研究针对参与两项随机3期临床试验(TRIBE和TRIBE2)的患者进行FOLFOXIRI/bev治疗效果的汇总分析,在该研究中主要比较了FOLFOXIRI/bev和doublets(FOLFOX(5-氟尿嘧啶、L-亚叶酸和奥沙利铂)或FOLFIRI(5-氟尿嘧啶、L-亚叶酸和伊立替康))/bev之间的效果。并评估了治疗期间的缓解率、无进展生存期(第二PFS)和总生存期(第二OS)。而一线的RECIST(实体瘤疗效评价标准)反应以及OIFI(无奥沙利铂和伊立替康间隔)则作为重新引入FOLFOXIRI±bev的潜在预测指标。

TRIBE和TRIBE2汇总分析流程图

结果显示,相比于doublets±bev或其他治疗策略,接受FOLFOXIRI±bev的再次入院的患者的第二次PFS较长(分别为4.4个月、3.9个月和6.1个月),且似乎仅限于在一线治疗中获得缓解的患者(4.2个月和4.7个月对应6.9个月),患者的OIFI≥4个月(分别为6.5个月、4.6个月和7.2个月)。

一线FOLFOXIRI/bev治疗后的第二PFS 和第二OS期结果

总而言之,一线FOLFOXIRI/bev并不影响二线治疗的疗效。一线反应和更长的OIFI则与反应的改善、第二PFS期和FOLFOXIRI±bev治疗策略的重新引入相关,但并不影响第二OS期。


原始出处:

Rossini, D., Lonardi, S., Antoniotti, C. et al. Treatments after progression to first-line FOLFOXIRI and bevacizumab in metastatic colorectal cancer: a pooled analysis of TRIBE and TRIBE2 studies by GONO. Br J Cancer (07 October 2020).

 

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    2020-11-09 lovetcm

    #FOLFOXIRI##贝伐单抗#治疗转移性#结直肠癌#,贝伐越来越变成万金油!

    0

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    2020-10-19 1244c0ebm28暂无昵称

    学习学习

    0

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    2020-10-19 linlin2314
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    2020-10-18 陈小凤

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