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多中心II期研究:奥沙利铂方案停用后FOLFIRI联合贝伐单抗用于晚期或复发性结直肠癌(CR0802)

Multicenter phase II study of FOLFIRI plus bevacizumab after discontinuation of oxaliplatin-based regimen for advanced or recurrent colorectal cancer (CR0802).

作者信息

Suenaga Mitsukuni, Nishina Tomohiro, Mizunuma Nobuyuki, Yasui Hisateru, Ura Takashi, Denda Tadamichi, Ikeda Junichi, Esaki Taito, Nishisaki Hogara, Takano Yoshinao, Sugiyama Yasuyuki, Muro Kei

机构信息

Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan.

National Hospital Organization Shikoku Cancer Center, Kou 160 Minamiumemotomachi, Matsuyama, Ehime, 791-0280, Japan.

出版信息

BMC Cancer. 2015 Mar 25;15:176. doi: 10.1186/s12885-015-1175-3.

Abstract

BACKGROUND

To investigate the efficacy and safety of FOLFIRI plus bevacizumab regimen with irinotecan (180 mg/m(2)) in patients with advanced or recurrent colorectal cancer who were of the wild-type or heterozygous group for UGT1A1*28 and *6 polymorphisms and discontinued to oxaliplatin-based regimen, prospectively.

METHODS

The study population consisted of patients who had discontinued oxaliplatin-based regimen for any reason. The primary endpoint was the response rate. FOLFIRI and bevacizumab regimen [irinotecan: 180 mg/m(2), 5-fluorouracil infusion: 2400 mg/m(2), 5-fluorouracil bolus: 400 mg/m(2), levofolinate calcium: 200 mg/m(2), bevacizumab: 5 mg/kg] was repeated every 2 weeks for up to 24 cycles.

RESULTS

Ninety-four patients were enrolled; 93 patients were evaluated on safety, 94 patients on efficacy. The response rate was 10.1% (95% confidence interval (CI): 4.7-18.3%). The median time to treatment failure, progression-free survival, and overall survival were 4.1 months (95% CI: 2.8-4.8 months), 5.4 months (95% CI: 4.1-6.2 months), and 14.5 months (95% CI: 11.8-17.0 months), respectively. The treatment-related death was 1.1%, and the early death ≤30 days after the last study treatment was 1.1%. The incidence of grade 3 or higher adverse events was 60.2% for neutropenia, 23.7% for leukopenia, 9.7% for diarrhea, 6.5% for anorexia, and 5.4% for fatigue. All these adverse events and other adverse events were controllable.

CONCLUSIONS

FOLFIRI plus bevacizumab regimen with an initial irinotecan dose of 180 mg/m(2) exhibited an adequate antitumor effect and was confirmed to be manageable and tolerable in Japanese patients with advanced or recurrent colorectal cancer, who had discontinued oxaliplatin-based regimen.

TRIAL REGISTRATION

UMIN000001817 .

摘要

背景

前瞻性地研究FOLFIRI联合贝伐单抗方案(伊立替康剂量为180mg/m²)用于UGT1A1 28和6多态性野生型或杂合型的晚期或复发性结直肠癌患者且已停用基于奥沙利铂方案的疗效和安全性。

方法

研究人群包括因任何原因停用基于奥沙利铂方案的患者。主要终点为缓解率。FOLFIRI和贝伐单抗方案[伊立替康:180mg/m²,5-氟尿嘧啶静脉滴注:2400mg/m²,5-氟尿嘧啶推注:400mg/m²,亚叶酸钙:200mg/m²,贝伐单抗:5mg/kg]每2周重复一次,最多进行24个周期。

结果

94例患者入组;93例患者进行了安全性评估,94例患者进行了疗效评估。缓解率为(10.1%)(95%置信区间(CI):\(4.7%-18.3%))。治疗失败的中位时间、无进展生存期和总生存期分别为4.1个月(95%CI:2.8 - 4.8个月)、5.4个月(95%CI:4.1 - 6.2个月)和14.5个月(95%CI:11.8 - 17.0个月)。治疗相关死亡率为(1.1%),末次研究治疗后≤30天的早期死亡率为(1.1%)。3级或更高等级不良事件的发生率为:中性粒细胞减少症(60.2%),白细胞减少症(23.7%),腹泻(9.7%),厌食(6.5%),疲劳(5.4%)。所有这些不良事件和其他不良事件都是可控的。

结论

初始伊立替康剂量为180mg/m²的FOLFIRI联合贝伐单抗方案显示出足够的抗肿瘤效果,并且在已停用基于奥沙利铂方案的日本晚期或复发性结直肠癌患者中被证实是可管理和可耐受的。

试验注册号

UMIN000001817 。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/05f5/4376520/464824a6a45f/12885_2015_1175_Fig1_HTML.jpg

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