Larsen Finn Ole, Markussen Alice, Nielsen Dorte, Colville-Ebeling Bonnie, Riis Lene B, Jensen Benny V
Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte, Herlev, Denmark.
Oncology. 2017;93(3):191-196. doi: 10.1159/000475818. Epub 2017 May 23.
The aim of this study was to evaluate the efficacy and safety of combining irinotecan, bevacizumab, and cetuximab/panitumumab as a 4th-line treatment in patients with metastatic colorectal cancer.
All patients had KRAS wild-type metastatic colorectal cancer and had previously received fluoropyrimidine, oxaliplatin, irinotecan, and cetuximab/panitumumab in a 1st, 2nd, and 3rd line setting. Most patients had previously received bevacizumab as well. All patients had progressed within 3 months after the last given treatment before starting the triple combination therapy every second week.
Sixty-three patients were evaluated. The triple combination therapy was well tolerated. The median progression-free survival was 6.1 months, and the median overall survival was 11.9 months. Four patients (6%) obtained a partial response, and 40 (63%) had stable disease.
The combination of irinotecan, bevacizumab, and cetuximab/panitumumab is safe and shows a toxicity profile corresponding to what is expected from the agents alone. The results indicate that the combination in the 4th line may result in a high rate of disease control in heavily pretreated patients with metastatic colorectal cancer.
本研究旨在评估伊立替康、贝伐单抗和西妥昔单抗/帕尼单抗联合作为转移性结直肠癌患者的四线治疗方案的疗效和安全性。
所有患者均患有KRAS野生型转移性结直肠癌，且之前在一线、二线和三线治疗中接受过氟尿嘧啶、奥沙利铂、伊立替康以及西妥昔单抗/帕尼单抗治疗。大多数患者之前也接受过贝伐单抗治疗。所有患者在开始每两周一次的三联联合治疗前，在上次给予治疗后的3个月内病情均有进展。
对63例患者进行了评估。三联联合治疗耐受性良好。无进展生存期的中位数为6.1个月，总生存期中位数为11.9个月。4例患者（6%）获得部分缓解，40例患者（63%）病情稳定。
伊立替康、贝伐单抗和西妥昔单抗/帕尼单抗联合治疗是安全的，且显示出的毒性特征与单独使用这些药物时预期的相符。结果表明，在四线治疗中，该联合方案可能使接受过大量治疗的转移性结直肠癌患者实现较高的疾病控制率。
