Moosmann Nicolas, Heinemann Volker
Medizinische Klinik III, Klinikum Muenchen-Grosshadern, Marchioninistrasse 15, D-81377 München, Germany.
Expert Rev Anticancer Ther. 2008 Mar;8(3):319-29. doi: 10.1586/14737140.8.3.319.
Modern chemotherapy combinations for metastatic colorectal cancer (mCRC) comprise 5-fluorouracil (5-FU), folinic acid and irinotecan or oxaliplatin. Infusional 5-FU, folinic acid plus oxaliplatin (FOLFOX) is a standard of care not only for patients with stage IV disease, but also in the adjuvant setting of stage III colon cancer patients. The EGF receptor antibody, cetuximab, induces synergistic antitumor activity when combined with chemotherapy. In pretreated patients, cetuximab may restore the sensitivity to irinotecan and, therefore, has been registered in this setting. A number of Phase I and II trials investigated the combination of cetuximab plus oxaliplatin-based chemotherapy for the first-line treatment of mCRC. This combined cytotoxic and targeted treatment approach prooved to be safe and provided encouraging efficacy data, which are among the highest so far observed in the systemic treatment of mCRC. This review presents recent data on oxaliplatin, cetuximab and the combination of both for mCRC as well as possible future indications in the palliative, adjuvant and neoadjuvant setting of modern CRC treatment.
用于转移性结直肠癌（mCRC）的现代化疗方案包括5-氟尿嘧啶（5-FU）、亚叶酸和伊立替康或奥沙利铂。持续输注5-FU、亚叶酸加奥沙利铂（FOLFOX）不仅是IV期疾病患者的标准治疗方案，也是III期结肠癌患者辅助治疗的标准方案。表皮生长因子受体（EGF）抗体西妥昔单抗与化疗联合使用时可诱导协同抗肿瘤活性。在经预处理的患者中，西妥昔单抗可恢复对伊立替康的敏感性，因此已在该情况下获批使用。多项I期和II期试验研究了西妥昔单抗加奥沙利铂为基础的化疗联合用于mCRC一线治疗的情况。这种细胞毒性和靶向治疗相结合的方法被证明是安全的，并提供了令人鼓舞的疗效数据，这些数据是迄今为止在mCRC全身治疗中观察到的最高数据之一。本综述介绍了奥沙利铂、西妥昔单抗以及两者联合用于mCRC的最新数据，以及在现代结直肠癌治疗的姑息、辅助和新辅助治疗中可能的未来应用指征。
