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贝伐单抗治疗转移性结直肠癌的安全性和有效性:来自阿瓦斯汀(®)注册研究 - 有效性和安全性调查(ARIES)观察性队列研究的最终结果。

Safety and effectiveness of bevacizumab treatment for metastatic colorectal cancer: final results from the Avastin(®) Registry - Investigation of Effectiveness and Safety (ARIES) observational cohort study.

作者信息

Hurwitz H I, Bekaii-Saab T S, Bendell J C, Cohn A L, Kozloff M, Roach N, Mun Y, Fish S, Flick E D, Grothey A

机构信息

Division of Hematology and Oncology, Duke University Medical Center, Durham, NC, USA.

Department of Internal Medicine, The Ohio State University Medical Center, Columbus, OH, USA.

出版信息

Clin Oncol (R Coll Radiol). 2014 Jun;26(6):323-32. doi: 10.1016/j.clon.2014.03.001. Epub 2014 Mar 28.

Abstract

AIMS

The Avastin(®) Registry - Investigation of Effectiveness and Safety (ARIES) observational cohort study (OCS) was designed to prospectively examine outcomes associated with bevacizumab-containing treatment for metastatic colorectal cancer (mCRC) in a community-based setting, where patient populations are less restricted than those in randomised trials.

MATERIALS AND METHODS

Patients with mCRC who were eligible for bevacizumab in combination with chemotherapy in first- or second-line treatment were enrolled from November 2006 to September 2008. There were no protocol-specified treatment regimens; the dose and schedule of bevacizumab and chemotherapy were at the treating physician's discretion. The objectives in the ARIES OCS included analyses of progression-free survival (PFS), overall survival, treatment patterns and safety in each of the first- and second-line treatment cohorts.

RESULTS

ARIES enrolled 1550 patients with mCRC receiving first-line therapy with bevacizumab. The median follow-up time was 20.6 months. The median PFS in this cohort was 10.2 months (95% confidence interval 9.8-10.6) and the median overall survival was 23.2 months (95% confidence interval 21.2-24.8). In a separate cohort of 482 patients with second-line mCRC, the median follow-up time was 16.9 months, the median PFS and overall survival from the start of second-line treatment to the end of follow-up was 7.9 months (95% confidence interval 7.2-8.3) and 17.8 months (95% confidence interval 16.5-20.7), respectively. Incidences of known bevacizumab-associated adverse events in ARIES were generally consistent with those previously reported in OCSs and randomised trials.

CONCLUSION

Results from the prospective ARIES OCS add further evidence to support the effectiveness and safety of bevacizumab when added to first- and second-line treatment regimens for patients with mCRC in community treatment settings.

摘要

目的

阿瓦斯汀(®)疗效与安全性调查登记研究(ARIES)观察性队列研究(OCS)旨在前瞻性地研究在社区环境中,接受含贝伐单抗治疗的转移性结直肠癌(mCRC)患者的相关结局,该环境下的患者群体限制比随机试验中的患者群体少。

材料与方法

2006年11月至2008年9月纳入了符合在一线或二线治疗中使用贝伐单抗联合化疗条件的mCRC患者。没有方案规定的治疗方案;贝伐单抗和化疗的剂量及疗程由治疗医生自行决定。ARIES OCS的目标包括分析一线和二线治疗队列中每个队列的无进展生存期(PFS)、总生存期、治疗模式和安全性。

结果

ARIES纳入了1550例接受贝伐单抗一线治疗的mCRC患者。中位随访时间为20.6个月。该队列的中位PFS为10.2个月(95%置信区间9.8 - 10.6),中位总生存期为23.2个月(95%置信区间21.2 - 24.8)。在另一个由482例二线mCRC患者组成的队列中,中位随访时间为16.9个月,从二线治疗开始到随访结束的中位PFS和总生存期分别为7.9个月(95%置信区间7.2 - 8.3)和17.8个月(95%置信区间16.5 - 20.7)。ARIES中已知的与贝伐单抗相关的不良事件发生率与先前观察性队列研究和随机试验中报告的发生率总体一致。

结论

前瞻性ARIES OCS的结果进一步证明,在社区治疗环境中,将贝伐单抗添加到mCRC患者的一线和二线治疗方案中是有效且安全的。

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