Thuss-Patience Peter C, Reichardt Peter, Riess Hanno, Kretzschmar Albrecht
Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Medizinische Klinik mit Schwerpunkt Hämatologie und Onkologie, Berlin.
Med Klin (Munich). 2006 Feb 15;101(2):114-9. doi: 10.1007/s00063-006-1016-x.
Considerable progress has been made in the treatment of colorectal cancer. Many new results have been presented at the annual meeting of the American Society of Clinical Oncology (ASCO) in May 2005 at Orlando, FL, USA.
This update describes the highlights of the ASCO 2005 conference and the most recent publications in this field.
Therapy of metastatic colorectal cancer: studies could demonstrate that capecitabine can possibly replace 5-fluorouracil (5-FU) in combination regimens with oxaliplatin. The EGF receptor antibody cetuximab shows activity as single agent and in combination with irinotecan. Combination with oxaliplatin/5-FU is under investigation. The VEGF antibody bevacizumab leads to improved efficacy in combination with all chemotherapies investigated so far, but shows no efficacy as single agent. Adjuvant therapy of colon cancer: oxaliplatin and 5-FU improves the disease-free survival compared with 5-FU regimens and is the new standard adjuvant treatment for stage III disease. Capecitabine demonstrates better tolerability and at least equal efficacy as 5-FU bolus regimens and should replace these regimens whenever an oxaliplatin-based therapy is not chosen. Irinotecan does not improve disease-free survival and has no proven benefit in the adjuvant setting. Monoclonal antibodies are integrated in new adjuvant trials.
结直肠癌治疗已取得显著进展。2005年5月在美国佛罗里达州奥兰多市举行的美国临床肿瘤学会（ASCO）年会上公布了许多新成果。
本综述介绍了2005年ASCO会议的要点以及该领域的最新出版物。
转移性结直肠癌的治疗：研究表明，在与奥沙利铂联合的方案中，卡培他滨可能可以替代5-氟尿嘧啶（5-FU）。表皮生长因子受体抗体西妥昔单抗作为单一药物以及与伊立替康联合使用时均显示出活性。与奥沙利铂/5-FU联合使用的研究正在进行中。血管内皮生长因子抗体贝伐单抗与目前所研究的所有化疗联合使用时可提高疗效，但作为单一药物则无疗效。结肠癌的辅助治疗：与5-FU方案相比，奥沙利铂和5-FU可提高无病生存率，是III期疾病新的标准辅助治疗方法。卡培他滨耐受性更好，疗效至少与5-FU推注方案相当，在不选择基于奥沙利铂的治疗时应取代这些方案。伊立替康不能提高无病生存率，在辅助治疗中未证实有获益。单克隆抗体已纳入新的辅助治疗试验。
