Taichung Veterans General Hospital, Taichung, Taiwan.
Neoplasma. 2013;60(5):561-7. doi: 10.4149/neo_2013_073.
Cetuximab, either alone or in combination with chemotherapy, is approved for treatment of patients with metastatic colorectal cancer (mCRC). We reviewed retrospectively records of 50 patients with mCRC from a single center in Taiwan. All patients had ECOG performance status grade 2, histological diagnosis of advanced CRC based on RECIST criteria, and were given at least three cycles of chemotherapy plus cetuximab. We compared the effectiveness of therapy in patients with wild-type and mutant KRAS genes, assessed the overall response (OR) rate of patients with locally advanced or metastatic non-resectable CRC, and assessed the progression-free survival (PFS) time. The ten patients with KRAS mutations had poorer response rates than the 40 patients with the wild-type KRAS gene. Patients with the wild-type and mutant genes had similar progression free survival (PFS) status and median time to PFS. The median overall survival time was significantly greater in patients with the wild-type gene than in those with the mutant gene (28.77 ± 6.43 months vs. 15.13 ± 0.50 months, p=0.014). Taiwanese patients with mCRC respond better to a cetuximab plus chemotherapy regime if their tumors have the wild-type KRAS gene.
西妥昔单抗，无论是单独使用还是与化疗联合使用，均被批准用于转移性结直肠癌（mCRC）患者的治疗。我们回顾性分析了来自台湾某单一中心的 50 例 mCRC 患者的记录。所有患者 ECOG 体能状态评分为 2 分，组织学诊断为基于 RECIST 标准的晚期 CRC，并且至少接受了三个周期的化疗加西妥昔单抗治疗。我们比较了 KRAS 基因野生型和突变型患者的治疗效果，评估了局部晚期或转移性不可切除 CRC 患者的总体缓解（OR）率，并评估了无进展生存期（PFS）。10 例 KRAS 突变患者的缓解率低于 40 例 KRAS 野生型基因患者。野生型和突变型基因患者的无进展生存（PFS）状况和中位 PFS 时间相似。野生型基因患者的中位总生存期明显长于突变型基因患者（28.77 ± 6.43 个月 vs. 15.13 ± 0.50 个月，p=0.014）。台湾 mCRC 患者如果肿瘤具有 KRAS 野生型基因，对西妥昔单抗联合化疗方案的反应更好。
