Cheng Ann-Lii, Li Jin, Vaid Ashok K, Ma Brigette Buig Yue, Teh Catherine, Ahn Joong B, Bello Maximino, Charoentum Chaiyut, Chen Li-Tzong, de Lima Lopes Gilberto, Ho Gwo F, Kong Hwai L, Lam Ka O, Liu Tian S, Park Young S, Sriuranpong Virote, Sudoyo Aru W, Wang Jaw-Yuan, Zhang Jun, Zhang Su Z, Ciardiello Fortunato, Köhne Clause-Henning, Shaw Michael, Kim Tae Won
Departments of Oncology and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Department of Medical Oncology, Fudan University Cancer Hospital, and Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
Clin Colorectal Cancer. 2014 Sep;13(3):145-55. doi: 10.1016/j.clcc.2014.06.004. Epub 2014 Jun 26.
Colorectal cancer (CRC) is among the most common cancers worldwide, but marked epidemiological differences exist between Asian and non-Asian populations. Hence, a consensus meeting was held in Hong Kong in December 2012 to develop Asia-specific guidelines for the management of metastatic CRC (mCRC). A multidisciplinary expert panel, consisting of 23 participants from 10 Asian and 2 European countries, discussed current guidelines for colon or rectal cancer and developed recommendations for adapting these guidelines to Asian clinical practice. Participants agreed that mCRC management in Asia largely follows international guidelines, but they proposed a number of recommendations based on regional 'real-world' experience. In general, participants agreed that 5-fluorouracil (5-FU) infusion regimens in doublets can be substituted with UFT (capecitabine, tegafur-uracil) and S1 (tegafur, 5-chloro-2,4-dihydroxypyridine and oxonic acid), and that the monoclonal antibodies cetuximab and panitumumab are recommended for KRAS wild type tumors. For KRAS mutant tumors, bevacizumab is the preferred biological therapy. FOLFOX (folinic acid, 5-FU, and oxaliplatin) is preferred for initial therapy in Asian patients. The management of mCRC is evolving, and it must be emphasized that the recommendations presented here reflect current treatment practices and thus might change as more data become available.
结直肠癌（CRC）是全球最常见的癌症之一，但亚洲和非亚洲人群之间存在显著的流行病学差异。因此，2012年12月在香港召开了一次共识会议，以制定针对亚洲转移性结直肠癌（mCRC）管理的特定指南。一个多学科专家小组由来自10个亚洲国家和2个欧洲国家的23名参与者组成，讨论了当前的结肠癌或直肠癌指南，并制定了使这些指南适用于亚洲临床实践的建议。参与者一致认为，亚洲的mCRC管理在很大程度上遵循国际指南，但他们根据区域“实际情况”经验提出了一些建议。总体而言，参与者一致认为，双联5-氟尿嘧啶（5-FU）输注方案可用替吉奥（卡培他滨、替加氟-尿嘧啶）和S-1（替加氟、5-氯-2,4-二羟基吡啶和奥昔嘌醇）替代，并且推荐将西妥昔单抗和帕尼单抗单克隆抗体用于KRAS野生型肿瘤。对于KRAS突变型肿瘤，贝伐单抗是首选的生物治疗方法。FOLFOX（亚叶酸、5-FU和奥沙利铂）是亚洲患者初始治疗的首选方案。mCRC的管理正在不断发展，必须强调的是，这里提出的建议反映了当前的治疗实践，因此可能会随着更多数据的获得而改变。
