Division of Hematology/Oncology, Department of Medicine, Section of GI Cancers and Experimental Therapeutics, Tufts University School of Medicine, Boston, MA 02111, USA.
Anticancer Res. 2013 Jun;33(6):2377-80.
Studies carried out through the past two decades have evidenced that addition of bevacizumab to chemotherapy improves the efficacy both in first-line and second-line treatment in patients with metastatic colorectal cancer. Benefit of adding bevacizumab to second-line regimen after failing a bevacizumab-containing regimen, or aflibercept plus FOLFIRI) (irinotecan, 5-FU and leucovorin) after failing first-line oxaliplatin regimen with or without bevacizumab or regorafenib as a salvage therapy, do indicate the addiction to anti-vascular endothelial growth factor (VEGF) agents in these patients. This concept also lends some support from the NSABP C-08 adjuvant trial of colon cancer which showed very substantial improvement in time-to-recurrence for the one year of bevacizumab administration, but this benefit was quickly lost once the drug was stopped. The author reviews the data on anti-VEGF therapy in metastatic colorectal cancer.
过去二十年的研究表明，贝伐珠单抗联合化疗可提高转移性结直肠癌一线和二线治疗的疗效。贝伐珠单抗联合化疗方案治疗失败后（或贝伐珠单抗联合奥沙利铂/卡培他滨或贝伐珠单抗联合 FOLFIRI 治疗失败后）添加贝伐珠单抗，或一线治疗奥沙利铂/卡培他滨或贝伐珠单抗联合 FOLFIRI 治疗失败后添加瑞戈非尼作为挽救性治疗，均能获益，这表明这些患者对抗血管内皮生长因子（VEGF）药物有依赖性。这一概念也得到了 NSABP C-08 结肠癌辅助试验的支持，该试验显示贝伐珠单抗治疗一年可显著延长无复发生存时间，但一旦停药，这种获益很快就会消失。作者回顾了转移性结直肠癌抗 VEGF 治疗的数据。
