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帕尼单抗联合伊立替康每 3 周治疗方案对野生型 K-RAS 转移性结直肠癌二线治疗有效且方便。

Panitumumab and irinotecan every 3 weeks is an active and convenient regimen for second-line treatment of patients with wild-type K-RAS metastatic colorectal cancer.

机构信息

Medical Oncology Department, Ramón y Cajal University Hospital, Ctra. Colmenar Viejo Km. 9,1, 28034, Madrid, Spain.

出版信息

Clin Transl Oncol. 2013 Sep;15(9):705-11. doi: 10.1007/s12094-012-0993-x. Epub 2013 Jan 29.

DOI:10.1007/s12094-012-0993-x
PMID:23359181
Abstract

PURPOSE

To evaluate the efficacy and safety profile of the combination of panitumumab and irinotecan every 3 weeks in a phase II trial as second-line treatment in patients with advanced wild-type (WT) K-RAS colorectal cancer (CRC).

METHODS

Fifty-three patients received 9 mg/kg of panitumumab followed by 350 mg/m(2) of irinotecan every 21 days until disease progression, unacceptable toxicity or consent withdrawal.

RESULTS

Median age of patients included was 67 years. All patients had previously received 5-fluorouracil, 84 % oxaliplatin and 8 % irinotecan as first-line treatment. Patients received a median of five infusions of panitumumab and irinotecan. On an intention-to-treat analysis, 12 patients (23 %) achieved partial responses and 22 patients (41 %) achieved disease stabilization. Median progression-free survival and overall survival were 4.5 and 15.1 months, respectively. The most frequent treatment-related severe toxicities per patient were diarrhoea (35.8 %), followed by skin rash (32.1 %), asthenia (18.9 %) and neutropenia (13.2 %). A significant association between clinical response and incidence and grade of skin toxicity was observed (p = 0.0032).

CONCLUSION

This study shows that the administration of panitumumab plus irinotecan every 3 weeks is safe, active and feasible as second-line treatment in patients with advanced WT K-RAS CRC.

摘要

目的

评估帕尼单抗联合伊立替康每 3 周方案作为野生型(WT)K-RAS 结直肠癌(CRC)二线治疗的疗效和安全性。

方法

53 例患者接受 9mg/kg 帕尼单抗治疗,随后每 21 天给予 350mg/m2伊立替康,直至疾病进展、不可接受的毒性或患者退出。

结果

纳入患者的中位年龄为 67 岁。所有患者均接受过氟尿嘧啶、奥沙利铂(84%)和伊立替康(8%)作为一线治疗。患者接受帕尼单抗和伊立替康治疗的中位数为 5 个疗程。意向治疗分析中,12 例(23%)患者获得部分缓解,22 例(41%)患者疾病稳定。中位无进展生存期和总生存期分别为 4.5 个月和 15.1 个月。最常见的治疗相关严重毒性为腹泻(35.8%),其次是皮疹(32.1%)、乏力(18.9%)和中性粒细胞减少(13.2%)。观察到临床反应与皮肤毒性的发生率和严重程度之间存在显著相关性(p=0.0032)。

结论

该研究表明,帕尼单抗联合伊立替康每 3 周方案作为晚期 WT K-RAS CRC 二线治疗是安全、有效且可行的。

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Panitumumab combined with irinotecan for patients with KRAS wild-type metastatic colorectal cancer refractory to standard chemotherapy: a GERCOR efficacy, tolerance, and translational molecular study.帕尼单抗联合伊立替康治疗标准化疗耐药的 KRAS 野生型转移性结直肠癌患者:GERCOR 的疗效、耐受性和转化分子研究。
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Randomized, phase III trial of panitumumab with infusional fluorouracil, leucovorin, and oxaliplatin (FOLFOX4) versus FOLFOX4 alone as first-line treatment in patients with previously untreated metastatic colorectal cancer: the PRIME study.随机、III 期临床试验:帕尼单抗联合氟尿嘧啶、亚叶酸钙和奥沙利铂(FOLFOX4)对比 FOLFOX4 一线治疗未经治疗的转移性结直肠癌患者:PRIME 研究。
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帕尼单抗联合基于伊立替康的化疗治疗转移性结直肠癌的疗效和安全性:一项荟萃分析。
Medicine (Baltimore). 2016 Dec;95(50):e5284. doi: 10.1097/MD.0000000000005284.
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The homeobox only protein homeobox (HOPX) and colorectal cancer.仅含同源盒结构域的蛋白同源盒(HOPX)与结直肠癌
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J Clin Oncol. 2010 Nov 1;28(31):4706-13. doi: 10.1200/JCO.2009.27.6055. Epub 2010 Oct 4.
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Cetuximab administered once every second week to patients with metastatic colorectal cancer: a two-part pharmacokinetic/pharmacodynamic phase I dose-escalation study.西妥昔单抗每两周一次给药用于转移性结直肠癌患者:一项两部分药代动力学/药效学Ⅰ期剂量递增研究。
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Phase III noninferiority trial comparing irinotecan with oxaliplatin, fluorouracil, and leucovorin in patients with advanced colorectal carcinoma previously treated with fluorouracil: N9841.一项III期非劣效性试验,比较伊立替康与奥沙利铂、氟尿嘧啶和亚叶酸钙用于先前接受过氟尿嘧啶治疗的晚期结直肠癌患者:N9841。
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Oxaliplatin plus irinotecan compared with irinotecan alone as second-line treatment after single-agent fluoropyrimidine therapy for metastatic colorectal carcinoma.奥沙利铂联合伊立替康与单用伊立替康作为单药氟嘧啶治疗转移性结直肠癌后的二线治疗比较。
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EPIC: phase III trial of cetuximab plus irinotecan after fluoropyrimidine and oxaliplatin failure in patients with metastatic colorectal cancer.EPIC:西妥昔单抗联合伊立替康用于氟嘧啶和奥沙利铂治疗失败的转移性结直肠癌患者的III期试验。
J Clin Oncol. 2008 May 10;26(14):2311-9. doi: 10.1200/JCO.2007.13.1193. Epub 2008 Apr 7.
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Irinotecan/fluorouracil combination in first-line therapy of older and younger patients with metastatic colorectal cancer: combined analysis of 2,691 patients in randomized controlled trials.伊立替康/氟尿嘧啶联合方案用于老年和年轻转移性结直肠癌患者的一线治疗:2691例随机对照试验患者的综合分析
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