Bai Long, Zhang Dong-Sheng, Wu Wen-Jing, Ren Chao, Wang De-Shen, Wang Feng, Qiu Miao-Zhen, Xu Rui-Hua
Department of Medical Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
Med Oncol. 2015 Feb;32(2):469. doi: 10.1007/s12032-014-0469-7. Epub 2015 Jan 13.
After the approval of bevacizumab for the first-line treatment of metastatic colorectal cancer (mCRC) in China, published information was still limited. This observational cohort study enrolled 175 mCRC patients who initiated bevacizumab-containing first-line chemotherapies at Sun Yet-sen University Cancer Center. Backbone chemotherapies included FOLFIRI (45.6 %), FOLFOX (34.9 %), and XELOX (19.5 %). Effectiveness data, safety profiles, and treatment patterns were collected and compared between oxaliplatin- and irinotecan-based groups. The median treatment durations of bevacizumab in first-line and total were equivalent between oxaliplatin- and irinotecan-based group (5.0 vs. 4.8 and 6.0 vs. 5.9 months, respectively). Median progression-free survival (PFS) was 10.6 months, and median overall survival (OS) was 24.2 months in entire population. No significant difference was found between irinotecan- and oxaliplatin-based groups in PFS (10.8 vs. 10.1 months, p = 0.21) or in OS (27.5 vs. 23.7 months, p = 0.68). Overall response rate in entire population was 38.3 %, and the disease control rate was 86.3 %. Bevacizumab-associated serious adverse events included hypertension (4.2 %), bleeding (3.6 %), proteinuria (3.0 %), venous thromboembolism (0.6 %), and wound-healing complications (0.6 %). Curative-intent surgery after conversion chemotherapy was carried out in 23 patients (13.7 %). Multivariate analyses showed that maintenance therapy (p = 0.001), resection of metastatic sites (p = 0.002), and disease-free interval (p = 0.003) were independent prognostic factors for OS survival. In spite of small discrepancies in treatment patterns, irinotecan- and oxaliplatin-based chemotherapeutic regimens are equally compatible partners for bevacizumab in first-line Chinese mCRC treatment.
在中国贝伐珠单抗被批准用于转移性结直肠癌（mCRC）的一线治疗后，已发表的相关信息仍然有限。这项观察性队列研究纳入了175例在中山大学肿瘤防治中心开始含贝伐珠单抗一线化疗的mCRC患者。主要化疗方案包括FOLFIRI（45.6%）、FOLFOX（34.9%）和XELOX（19.5%）。收集并比较了基于奥沙利铂和基于伊立替康的治疗组之间的疗效数据、安全性概况和治疗模式。基于奥沙利铂和基于伊立替康的治疗组中，贝伐珠单抗一线治疗和总治疗的中位持续时间相当（分别为5.0个月对4.8个月和6.0个月对5.9个月）。整个人群的中位无进展生存期（PFS）为10.6个月，中位总生存期（OS）为24.2个月。基于伊立替康和基于奥沙利铂的治疗组在PFS（10.8个月对10.1个月，p = 0.21）或OS（27.5个月对23.7个月，p = 0.68）方面未发现显著差异。整个人群的总缓解率为38.3%，疾病控制率为86.3%。与贝伐珠单抗相关的严重不良事件包括高血压（4.2%）、出血（3.6%）、蛋白尿（3.0%）、静脉血栓栓塞（0.6%）和伤口愈合并发症（0.6%）。23例患者（13.7%）在转化化疗后接受了根治性手术。多因素分析显示，维持治疗（p = 0.001）、转移部位切除（p = 0.002）和无病间期（p = 0.003）是OS生存的独立预后因素。尽管治疗模式存在微小差异，但在中国mCRC一线治疗中，基于伊立替康和基于奥沙利铂的化疗方案对于贝伐珠单抗而言都是同样合适的搭档。
