Punt Cornelis J A, Simkens Lieke H J, Koopman Miriam
From the Department of Medical Oncology, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands; Department of Medical Oncology, University Medical Centre Utrecht, Utrecht, Netherlands.
Am Soc Clin Oncol Educ Book. 2015:85-90. doi: 10.14694/EdBook_AM.2015.35.85.
With the currently available cytotoxic and targeted drugs, metastatic colorectal cancer (mCRC) may be controlled by systemic treatment for a substantial period of time. However, many questions remain about the optimal use of drugs and duration of treatment. The feasibility of chemotherapy-free intervals has been studied in patients with mCRC treated with chemotherapy alone, but the results are conflicting. Current data show that oxaliplatin may be safely interrupted, but they do not allow a firm conclusion on the safety of a full treatment break of chemotherapy. For targeted therapy, continuous inhibition of intracellular signaling by prolonged administration would theoretically be beneficial for efficacy of treatment. Recent data support the use of maintenance treatment with chemotherapy and bevacizumab. No data on the optimal duration of treatment with anti-epidermal growth factor receptor (EGFR) agents are currently available.
使用目前可用的细胞毒性药物和靶向药物，转移性结直肠癌（mCRC）可通过全身治疗得到较长时间的控制。然而，关于药物的最佳使用和治疗持续时间仍存在许多问题。在仅接受化疗的mCRC患者中，已经研究了无化疗间期的可行性，但结果相互矛盾。目前的数据表明奥沙利铂可以安全中断，但对于完全停止化疗的安全性尚无确凿结论。对于靶向治疗，理论上通过延长给药持续抑制细胞内信号传导对治疗疗效有益。最近的数据支持使用化疗和贝伐单抗进行维持治疗。目前尚无关于抗表皮生长因子受体（EGFR）药物最佳治疗持续时间的数据。
