Devaux Madeline, Gerard Laura, Richard Corentin, Bengrine-Lefevre Leila, Vincent Julie, Schmitt Antonin, Ghiringhelli François
Department of Medical Oncology, Centre George François Leclerc, Dijon 21000, France.
Platform of Transfer in Biological Oncology, Centre George François Leclerc, Dijon 21000, France.
World J Clin Oncol. 2019 Feb 24;10(2):75-85. doi: 10.5306/wjco.v10.i2.75.
The treatment of metastatic colorectal cancer (mCRC) relies of chemotherapy. The efficacy of the standard FOLFIRI-therapy could be improved by a modification of the regimen by splitting the dose of irinotecan on day 1 and day 3 in the FOLFIRI3 regimen.
To determine safety and efficacy of FOLFIRI3 regimen.
This is a monocentric retrospective study evaluating the efficacy and safety of the FOLFIRI3 regimen given alone or in combination with bevacizumab or aflibercept in patients with previously treated mCRC.
One hundred and fifty-three consecutive patients were included (18 treated with FOLFIRI3, 99 with FOLFIRI3 plus bevacizumab and 36 with FOLFIRI3 plus aflibercept). The overall response rate (ORR) and disease control rate were 51% and 62%, respectively. Similar ORRs were observed in all 3 cohorts. Median progression-free survival (PFS) and overall survival (OS) were 3.9 mo (95%CI: 3.2-4.9) and 9.4 mo (95%CI: 6.6-12), respectively. Median PFS and OS values were improved in the FOLFIRI3 plus aflibercept group. The most common grade 3-4 adverse events were diarrhoea (21.6%) and neutropenia (11.8%), and these toxicities were more frequent in the FOLFIRI3 plus aflibercept group. According to the multivariate Cox proportional model, previous surgery of metastasis and aflibercept were associated with outcomes.
The modification of the FOLFIRI regimen impacted treatment response of mCRC patients. The addition of an antiangiogenic agent, in particular aflibercept, enhanced the clinical benefit and improved survival.
转移性结直肠癌（mCRC）的治疗依赖于化疗。在FOLFIRI3方案中，通过在第1天和第3天分次给予伊立替康来调整方案，可提高标准FOLFIRI疗法的疗效。
确定FOLFIRI3方案的安全性和疗效。
这是一项单中心回顾性研究，评估FOLFIRI3方案单独使用或与贝伐单抗或阿柏西普联合使用对既往接受过治疗的mCRC患者的疗效和安全性。
共纳入153例连续患者（18例接受FOLFIRI3治疗，99例接受FOLFIRI3加贝伐单抗治疗，36例接受FOLFIRI3加阿柏西普治疗）。总缓解率（ORR）和疾病控制率分别为51%和62%。在所有3个队列中观察到相似的ORR。中位无进展生存期（PFS）和总生存期（OS）分别为3.9个月（95%CI：3.2 - 4.9）和9.4个月（95%CI：6.6 - 12）。FOLFIRI3加阿柏西普组的中位PFS和OS值有所改善。最常见的3 - 4级不良事件是腹泻（21.6%）和中性粒细胞减少（11.8%），这些毒性在FOLFIRI3加阿柏西普组中更常见。根据多变量Cox比例模型，既往转移灶手术和阿柏西普与预后相关。
FOLFIRI方案的调整影响了mCRC患者的治疗反应。添加抗血管生成药物，特别是阿柏西普，增强了临床获益并改善了生存期。
