Kang Byung Woog, Kim Tae Won, Lee Jae-Lyun, Ryu Min-Hee, Chang Heung Moon, Yu Chang Sik, Kim Jin Cheon, Kim Jong Hoon, Kang Yoon-Koo, Lee Jung Shin
Section of Oncology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul 138-736, Korea.
Med Oncol. 2009;26(1):32-7. doi: 10.1007/s12032-008-9077-8. Epub 2008 May 22.
Bevacizumab, a monoclonal antibody against vascular endothelial growth factor, has shown clinical activity in metastatic colorectal cancer patients when used as either a first-line or second-line treatment. Here, we evaluated the efficacy and safety of bevacizumab plus FOLFIRI (irinotecan, 5-fluorouracil, and leucovorin) or FOLFOX (oxaliplatin, 5-fluorouracil, and leucovorin) in metastatic colorectal cancer cases after failure to FOLFIRI and FOLFOX. Between October 2004 and February 2007, the data on 42 patients with metastatic colorectal cancer after failure of FOLFIRI and FOLFOX were reviewed retrospectively. All patients were treated with bevacizumab plus FOLFIRI or FOLFOX. The median patient age was 57.0 years. The ECOG performance status was 0 or 1 in 27 patients (64.3%). The number of previous chemotherapy regimens was >/=3 in 35 patients (83.3%). Thirty-nine patients were evaluable for response. Four patients had partial responses (PRs) and no patient had a complete response (CR), giving an overall response rate of 9.5%. Twenty-two patients (52.4%) had stable disease and 13 patients (31.0%) showed progressive disease. With a median follow-up time of 12.9 months (range 1.0-30.0 months), the median progression-free survival time and the median overall survival time were 5.3 and 9.5 months, respectively. Grade 3 or 4 neutropenia developed in 18 patients (42.9%), including febrile neutropenia in 4 patients (9.5%). Common non-hematologic toxicities were fatigue (21.4%), neuropathy (21.4%), and mucositis (21.4%). Grade 2 or 3 hypertension occurred in 4 patients (9.6%), and grade 1 or 2 proteinuria was seen in 16 patients (38.1%). The frequencies of adverse events related BV, such as bleeding, thrombosis, and gastrointestinal perforation, were within the ranges of previous reports. However, there were no treatment-related deaths. The combination of bevacizumab plus FOLFIRI or FOLFOX showed modest activity and was relatively tolerable in patients with metastatic colorectal cancer refractory to both FOLFIRI and FOLFOX.
贝伐单抗是一种抗血管内皮生长因子的单克隆抗体，在转移性结直肠癌患者中作为一线或二线治疗使用时已显示出临床活性。在此，我们评估了贝伐单抗联合FOLFIRI（伊立替康、5-氟尿嘧啶和亚叶酸钙）或FOLFOX（奥沙利铂、5-氟尿嘧啶和亚叶酸钙）在FOLFIRI和FOLFOX治疗失败后的转移性结直肠癌病例中的疗效和安全性。在2004年10月至2007年2月期间，对42例FOLFIRI和FOLFOX治疗失败后的转移性结直肠癌患者的数据进行了回顾性分析。所有患者均接受贝伐单抗联合FOLFIRI或FOLFOX治疗。患者中位年龄为57.0岁。27例患者（64.3%）的东部肿瘤协作组（ECOG）体能状态为0或1。35例患者（83.3%）既往化疗方案数≥3。39例患者可评估疗效。4例患者有部分缓解（PR），无患者完全缓解（CR），总缓解率为9.5%。22例患者（52.4%）疾病稳定，13例患者（31.0%）疾病进展。中位随访时间为12.9个月（范围1.0 - 30.0个月），中位无进展生存期和中位总生存期分别为5.3个月和9.5个月。18例患者（42.9%）发生3级或4级中性粒细胞减少，其中4例患者（9.5%）发生发热性中性粒细胞减少。常见的非血液学毒性为疲劳（21.4%）、神经病变（21.4%）和黏膜炎（21.4%）。4例患者（9.6%）发生2级或3级高血压，16例患者（38.1%）出现1级或2级蛋白尿。与贝伐单抗相关的不良事件如出血、血栓形成和胃肠道穿孔的发生率在既往报告范围内。然而，没有与治疗相关的死亡病例。贝伐单抗联合FOLFIRI或FOLFOX在对FOLFIRI和FOLFOX均耐药的转移性结直肠癌患者中显示出适度活性且相对耐受性良好。
