SDI Health, Plymouth Meeting; Leonard Davis Institute for Health Economics and Policy, University of Pennsylvania, Philadelphia; College of Medicine, Thomas Jefferson University, Philadelphia, PA; Amgen, Thousand Oaks, CA.
J Oncol Pract. 2010 Nov;6(6):301-7. doi: 10.1200/JOP.2010.000072.
With the emergence of new chemotherapies and biologic agents in the treatment of metastatic colorectal cancer (mCRC), the optimal combination and sequencing of these therapies are yet to be determined. This study examined the extent and pattern of chemotherapy and biologic therapy use by line of treatment. Biologic continuation and dose escalation were also examined.
This study used an integrated electronic medical record database of 91 US oncology practices. Records were analyzed for 1,655 adult patients with mCRC who were treated from January 1, 2004 to January 31, 2008 with systemic therapy and could be observed for ≥ 3 months beyond their diagnosis of metastatic disease. Combination and sequence of individual drugs and regimens were examined.
For first-line therapy, the most common chemotherapy backbone was infused fluorouracil, leucovorin, and oxaliplatin (FOLFOX; 40.5% of patients), and the most common treatment regimen was FOLFOX plus bevacizumab (26.2%). For second-line therapy, fluorouracil, leucovorin, and irinotecan (FOLFIRI) was the most common chemotherapy backbone (25.7%), and FOLFIRI plus bevacizumab was the most common treatment regimen (18.3%). Across the study period, 68.6%, 22%, and 7% of patients received bevacizumab, cetuximab, and panitumumab, respectively. Among 412 patients receiving bevacizumab-containing regimens as first-line therapy who then received second-line therapy, 58% continued receiving bevacizumab, with dose escalation observed in 44%.
The most commonly used chemotherapy backbones for mCRC treatment were first-line FOLFOX and second-line FOLFIRI. Bevacizumab was the most frequently administered biologic therapy. Continuation and dose escalation with bevacizumab were frequently observed across lines of therapy.
随着新的化疗药物和生物制剂在转移性结直肠癌（mCRC）治疗中的出现，这些疗法的最佳组合和序贯应用仍有待确定。本研究通过治疗线检查了化疗和生物治疗的应用程度和模式。还检查了生物治疗的延续和剂量升级。
本研究使用了美国 91 家肿瘤学实践的综合电子病历数据库。对 2004 年 1 月 1 日至 2008 年 1 月 31 日接受系统治疗且转移性疾病诊断后至少可观察 3 个月的 1655 例 mCRC 成年患者的记录进行了分析。检查了个体药物和方案的组合和顺序。
对于一线治疗，最常见的化疗骨干是氟尿嘧啶、亚叶酸钙和奥沙利铂（FOLFOX；40.5%的患者），最常见的治疗方案是 FOLFOX 加贝伐珠单抗（26.2%）。对于二线治疗，氟尿嘧啶、亚叶酸钙和伊立替康（FOLFIRI）是最常见的化疗骨干（25.7%），FOLFIRI 加贝伐珠单抗是最常见的治疗方案（18.3%）。在整个研究期间，分别有 68.6%、22%和 7%的患者接受了贝伐珠单抗、西妥昔单抗和帕尼单抗。在 412 例接受贝伐珠单抗联合方案作为一线治疗然后接受二线治疗的患者中，58%继续接受贝伐珠单抗，其中 44%观察到剂量升级。
mCRC 治疗中最常使用的化疗骨干是一线 FOLFOX 和二线 FOLFIRI。贝伐珠单抗是最常使用的生物治疗药物。在不同的治疗线中，经常观察到贝伐珠单抗的持续应用和剂量升级。
