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FOLFIRI 联合 panitumumab 治疗野生型 KRAS 和野生型 NRAS 转移性结直肠癌。

FOLFIRI plus panitumumab in the treatment of wild-type KRAS and wild-type NRAS metastatic colorectal cancer.

机构信息

Department of Medical Oncology, Okmeydani Training and Research Hospital, Sisli, Istanbul, Turkey.

出版信息

World J Surg Oncol. 2018 Mar 27;16(1):67. doi: 10.1186/s12957-018-1359-9.

Abstract

BACKGROUND

The aim of this study was to investigate the efficacy and safety of first-line panitumumab plus folinic acid, 5-fluorouracil and irinotecan (FOLFIRI) in patients with wild-type KRAS and wild-type NRAS metastatic colorectal cancer (mCRC).

METHODS

Patients with wild-type KRAS and wild-type NRAS mCRC presenting to the medical oncology department of the Okmeydani Training and Research Hospital in Istanbul, Turkey, between April 2014 and January 2018 were enrolled in this study.

RESULTS

A total of 64 patients (35 males and 29 females) with a median age of 59 (35-81) years old were enrolled. The median follow-up was 18.9 months, and the median progression-free survival was 13 months. The median overall survival (OS) was 26 months in the patients with wild-type KRAS and wild-type NRAS mCRC. It was 90.4% for the 6-month OS, 79.5% for the 1-year OS, 53.7% for the 2-year OS and 31.1% for the 3-year OS. The median OS of the patients who underwent metastasectomies was 40 [95% confidence interval (CI) = 19.9-60.1] months, and the median OS of the patients without metastasectomies was 22 (95% CI = 17.7-26.4) months. There was a statistically significant difference between these (P = 0.007).

CONCLUSION

The first-line FOLFIRI plus panitumumab was associated with favourable efficacy in the patients with wild-type KRAS and wild-type NRAS mCRC, and it was well tolerated. The removal of the metastases that became resectable after chemotherapy further prolonged the patients' survival.

TRIAL REGISTRATION

Retrospectively registered: 33886.

摘要

背景

本研究旨在探讨一线帕尼单抗联合亚叶酸、5-氟尿嘧啶和伊立替康(FOLFIRI)在野生型 KRAS 和野生型 NRAS 转移性结直肠癌(mCRC)患者中的疗效和安全性。

方法

土耳其伊斯坦布尔奥克梅丹尼培训与研究医院的肿瘤内科于 2014 年 4 月至 2018 年 1 月期间招募了本研究的患者,这些患者均为野生型 KRAS 和野生型 NRAS mCRC。

结果

共纳入 64 例患者(男 35 例,女 29 例),中位年龄为 59 岁(35-81 岁)。中位随访时间为 18.9 个月,中位无进展生存期为 13 个月。野生型 KRAS 和野生型 NRAS mCRC 患者的中位总生存期(OS)为 26 个月。6 个月 OS 为 90.4%,1 年 OS 为 79.5%,2 年 OS 为 53.7%,3 年 OS 为 31.1%。接受转移灶切除术的患者的中位 OS 为 40 个月(95%置信区间[CI]:19.9-60.1),未接受转移灶切除术的患者的中位 OS 为 22 个月(95%CI:17.7-26.4)。两者之间存在统计学差异(P=0.007)。

结论

一线 FOLFIRI 联合帕尼单抗治疗野生型 KRAS 和野生型 NRAS mCRC 疗效良好,且耐受性良好。化疗后可切除转移灶的切除进一步延长了患者的生存时间。

试验注册

回顾性注册:33886。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a05/5870197/0e29e394f715/12957_2018_1359_Fig1_HTML.jpg

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