更多并不一定更好——转移性结直肠癌的靶向治疗联合策略。
More is less -- combining targeted therapies in metastatic colorectal cancer.
机构信息
Department of Medical Oncology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
出版信息
Nat Rev Clin Oncol. 2009 Dec;6(12):731-3. doi: 10.1038/nrclinonc.2009.168.
Targeted agents directed at VEGF, such as bevacizumab, and EGFR, such as cetuximab and panitumumab, have become part of the standard treatment of metastatic colorectal cancer. Only a subset of patients seem to benefit from such treatment, and varying results have been observed when different lines of treatment are used in combination with different cytotoxic drugs. Preclinical and early clinical data have shown promising results for the combination of anti-VEGF and anti-EGFR treatment. However, two recent phase III trials, CAIRO2 and PACCE, have shown a detrimental effect of adding an anti-EGFR antibody to standard chemotherapy plus bevacizumab. We discuss issues that may explain these unexpected results.
针对 VEGF 的靶向药物，如贝伐珠单抗，以及针对 EGFR 的靶向药物，如西妥昔单抗和帕尼单抗，已成为转移性结直肠癌标准治疗的一部分。只有一部分患者似乎受益于这种治疗，并且当不同的治疗线与不同的细胞毒性药物联合使用时，观察到不同的结果。临床前和早期临床数据表明，抗 VEGF 和抗 EGFR 治疗的联合具有前景。然而，最近的两项 III 期临床试验 CAIRO2 和 PACCE 表明，在标准化疗加贝伐珠单抗的基础上添加抗 EGFR 抗体会产生不良影响。我们讨论了可能解释这些意外结果的问题。
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