Lin Li, Xu Jian-ming, Wang Yan, Ge Fei-jiao, Liu Lie-jun, Zhao Chuan-hua, Li Shan-shan, Liu Jian-zhi, Li Zhi-qiang
Department of Digestive Oncology, Affiliated Hospital of Academy of Military Medicical Sciences, Beijing 100071, China.
Zhonghua Zhong Liu Za Zhi. 2010 Oct;32(10):786-90.
To assess the efficacy and safety of bevacizumab plus irinotecan-based regimen for the first line treatment in metastatic colorectal cancer (mCRC) patients, and to investigate the correlation between serum tumor markers including CEA and CA19-9 and response as well as prognosis.
From May 2007 to July 2008, 67 previously untreated mCRC patients received treatment of IFL (n = 25), IFL plus Bevacizumab (n = 20) or FOLFIRI (n = 22). The treatment continued until disease progression or unacceptable toxicity. The data were retrospectively analyzed.
All patients were evaluable for response, survival and toxicity analysis. The objective response rate of IFL, IFL plus Bevacizumab or FOLFIRI regimen groups was 16.0% (4/25), 35.0% (7/20) and 18.2% (4/22), respectively (χ(2) = 6.026, P = 0.049). The median progression-free survival (PFS) of IFL plus bevacizumab group was 7.5 months, significantly improved as compared with 3.7 months in the IFL group and 4 months in FOLFIRI group (χ(2) = 11.97, P = 0.003). Of all 67 cases, the one-year survival rate was 47.0%, two-year survival rate was 27.0%, and the median overall survival (OS) was 13.0 months, with no significant difference among the three treatment groups (χ(2) = 3.42, P = 0.18). The serum CEA and CA19-9 levels were decreased after treatment, but with no significant difference among the three groups (P > 0.05). The common toxicity profiles of IFL and FOLFIRI regimens were diarrhea and neutropenia, while the toxicity related to bevacizumab was consistent with that documented in previous literature, such as hypertension, hemorrhage, cardiac toxicity and delayed wound healing.
The addition of bevacizumab to irinotecan-based regimen significantly improves the response rate and PFS in first-line treatment for patients with mCRC and its toxicity is well tolerated.
评估贝伐单抗联合以伊立替康为基础的方案一线治疗转移性结直肠癌（mCRC）患者的疗效和安全性，并探讨血清肿瘤标志物癌胚抗原（CEA）和糖类抗原19-9（CA19-9）与疗效及预后之间的相关性。
2007年5月至2008年7月，67例既往未接受过治疗的mCRC患者接受了IFL方案（n = 25）、IFL联合贝伐单抗方案（n = 20）或FOLFIRI方案（n = 22）治疗。治疗持续至疾病进展或出现不可接受的毒性反应。对数据进行回顾性分析。
所有患者均可进行疗效、生存及毒性分析。IFL方案组、IFL联合贝伐单抗方案组或FOLFIRI方案组的客观缓解率分别为16.0%（4/25）、35.0%（7/20）和18.2%（4/22）（χ(2)=6.026，P = 0.049）。IFL联合贝伐单抗组的中位无进展生存期（PFS）为7.5个月，与IFL组的3.7个月和FOLFIRI组的4个月相比有显著改善（χ(2)=11.97，P = 0.003）。67例患者中，1年生存率为47.0%，2年生存率为27.0%，中位总生存期（OS）为13.0个月，三组治疗组之间无显著差异（χ(2)=3.42，P = 0.18）。治疗后血清CEA和CA19-9水平降低，但三组之间无显著差异（P > 0.05）。IFL和FOLFIRI方案的常见毒性反应为腹泻和中性粒细胞减少，而与贝伐单抗相关的毒性反应与既往文献报道一致，如高血压、出血、心脏毒性和伤口愈合延迟。
在以伊立替康为基础的方案中添加贝伐单抗可显著提高mCRC患者一线治疗的缓解率和PFS，且其毒性耐受性良好。
