Guo Xi, Liu Tian-shu, Yu Yi-yi, Zhou Yu-hong, Chen Yong, Zhuang Rong-yuan, Cui Yue-hong
Department of Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Zhonghua Zhong Liu Za Zhi. 2013 Aug;35(8):604-7.
To assess the efficacy and safety of bevacizumab (BEV) plus chemotherapeutic agents in the treatment of metastatic colorectal cancer (mCRC).
Seventy-seven mCRC patients received BEV plus 5-Fu type, oxaliplatin or irinotecan-based chemotherapy. The clinical efficacy and bevacizumab-related adverse reactions were observed. The efficacy assessment was conducted after at least 2 cycles of BEV therapy. The adverse reactions were recorded in each therapy cycle. Among the 77 cases, 64 patients had finished the efficacy assessment. The adverse reactions in all patients were assessed.
The overall response rate (ORR) of BEV plus chemotherapy regimen was 18.75% (12/64), and the disease control rate (DCR) was 75.0% (48/64). In 27 patients who received the regimen as first-line treatment, the ORR reached 37.0% (10/27), while the DCR was 85.2%. Four patients with potentially resectable lesions became resectable after the regimen and received R0 resection of the liver metastases successfully. Twenty-five patients who received the regimen as second line therapy had poor result with ORR 8.0% and DCR 76.0%. Hypertension was observed in 12 cases, with 8 cases of grade 1, 3 cases of grade 2, 1 case of grade 3. Various bleedings occurred in 24/77 cases (31.2%), all were of grade 1-2, including 17 cases of epistaxis, grade 1 hemorrhoid bleeding in one case, hematuria in 3 case (2 of grade 1, 1 of grade 2), GI bleeding in 2 cases, hemoptysis in 1 case (grade 2), and proteinuria in 4 cases (grade 1). Intestinal perforation occurred in 1 case (0.3%). In two patients who had incomplete intestinal obstruction history appeared exacerbated intestinal obstruction symptoms after the application of BEV plus CPT11 regimen.
BEV plus chemotherapy regimen as first-line treatment can improve the ORR and DCR of mCRC patients. When it was used as second- or later-line therapy, it may display satisfied DCR, although with a poor efficacy. The bevacizumab-related toxicity is mild and can be well tolerated.
评估贝伐单抗（BEV）联合化疗药物治疗转移性结直肠癌（mCRC）的疗效和安全性。
77例mCRC患者接受BEV联合5-氟尿嘧啶类、奥沙利铂或伊立替康为基础的化疗。观察临床疗效及与贝伐单抗相关的不良反应。在至少2个周期的BEV治疗后进行疗效评估。在每个治疗周期记录不良反应。77例患者中，64例完成了疗效评估。评估了所有患者的不良反应。
BEV联合化疗方案的总缓解率（ORR）为18.75%（12/64），疾病控制率（DCR）为75.0%（48/64）。在27例接受该方案一线治疗的患者中，ORR达到37.0%（10/27），而DCR为85.2%。4例有潜在可切除病灶的患者在接受该方案治疗后变为可切除，并成功接受了肝转移灶的R0切除。25例接受该方案二线治疗的患者效果较差，ORR为8.0%，DCR为76.0%。观察到12例高血压，其中1级8例，2级3例，3级1例。24/77例（31.2%）发生各种出血，均为1-2级，包括鼻出血17例、1级痔疮出血1例、血尿3例（1级2例，2级1例）、胃肠道出血2例、咯血1例（2级）、蛋白尿4例（1级）。肠穿孔1例（0.3%）。2例有不完全性肠梗阻病史的患者在应用BEV联合CPT11方案后出现肠梗阻症状加重。
BEV联合化疗方案作为一线治疗可提高mCRC患者的ORR和DCR。当作为二线或更后线治疗时，虽然疗效较差，但可能显示出满意的DCR。与贝伐单抗相关的毒性较轻，耐受性良好。
