Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
J Surg Oncol. 2014 Mar;109(3):250-4. doi: 10.1002/jso.23500. Epub 2013 Dec 7.
Metastatic colon cancer patients are treated with the chemotherapy regimens, FOLFOX and FOLFIRI, in either order. So far, we cannot predict the response of chemotherapeutic agent, so it is necessary to find which regimen is adequate before starting chemotherapy.
Enrolled patients are randomized into either conventional treatment or planned treatment preceded by pretreatment genetic analysis. Blood samples of patients in planned treatment group (N = 53) were analyzed for the genetic polymorphism before selection of chemotherapeutic agents. Target genes were XPD-751, GSTP-1-105, XRCC1-399 for oxaliplatin, UGT1A1 for irinotecan. The response was measured by computed tomographic scan after completion of three cycles of chemotherapy.
Overall response rate was significantly higher in planned group (67.9% vs. 46.3%, P = 0.020). In FOLFOX group, response rate was significantly improved in the planned patients(77.1% vs. 50%, P = 0.018). In FOLFIRI group, the difference didn't reach statistical significance (50% vs. 42.5%, P = 0.776).
We found significantly improved response rates in the chemotherapy of metastatic colon cancer by pretreatment genetic analysis, especially in FOLFOX group.
转移性结肠癌患者采用 FOLFOX 和 FOLFIRI 化疗方案进行治疗，两种方案的使用顺序并无差异。到目前为止，我们还无法预测化疗药物的反应，因此在开始化疗之前，有必要找到合适的方案。
将入组患者随机分为常规治疗组或计划治疗组，计划治疗组在选择化疗药物前进行预处理基因分析。计划治疗组（N=53）的患者血液样本进行奥沙利铂相关的 XPD-751、GSTP-1-105、XRCC1-399 基因多态性，伊立替康相关的 UGT1A1 基因多态性分析。完成三个周期化疗后，通过计算机断层扫描测量反应。
计划组的总缓解率显著高于常规组（67.9% vs. 46.3%，P=0.020）。在 FOLFOX 组中，计划组的缓解率显著提高（77.1% vs. 50%，P=0.018）。在 FOLFIRI 组中，差异无统计学意义（50% vs. 42.5%，P=0.776）。
我们发现通过预处理基因分析，转移性结肠癌的化疗反应率显著提高，尤其是在 FOLFOX 组。
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