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完全手术后全身化疗联合西妥昔单抗治疗孤立性结直肠癌腹膜转移癌:COCHISE II期临床试验

Systemic chemotherapy plus cetuximab after complete surgery in the treatment of isolated colorectal peritoneal carcinoma: COCHISE phase II clinical trial.

作者信息

Evrard Serge, Desolneux Grégoire, Bellera Carine, Esnaud Thomas, Bécouarn Yves, Collet Denis, Chafai Najim, Marchal Francois, Cany Laurent, Lermite Emilie, Rivoire Michel, Mathoulin-Pélissier Simone

机构信息

Digestive Tumours Unit, Institut Bergonié, Comprehensive Cancer Centre, 229 Cours de l'Argonne, 33076, Bordeaux, France.

Univ. Bordeaux, 146 rue Léo Saignat, 33000, Bordeaux, France.

出版信息

BMC Res Notes. 2019 Jul 22;12(1):450. doi: 10.1186/s13104-019-4476-9.

Abstract

OBJECTIVE

The primary objective of this non-randomised phase II study was to evaluate the combination of systemic chemotherapy plus cetuximab after complete cytoreductive surgery (CCS) for treatment of isolated colorectal peritoneal carcinoma (CRPC). This multicentre, prospective phase II clinical trial was conducted in seven national cancer referral centres, however research published during study recruitment indicated cetuximab treatment as ineffective in patients with mutated KRAS genes, leading to an additional exclusion criterion to the current protocol, excluding patients with mutated KRAS genes. This significantly impacted recruitment and the study did not achieve the necessary recruitment of 46 patients.

RESULTS

Fourteen patients underwent CCS and were included in the study, however one did not provide informed consent and another received only one cycle of chemotherapy leading to 12 patients in the per protocol population for analysis. Adjuvant Folfox Cetuximab was administered when CCS was achieved for patients > 18 years with histologically proven CRPC and no other metastatic disease (liver, lungs, lymphadenopathy, etc.). CRPC median index was 5.00 (range: 1-17). Median PFS was 12.3 months [95% CI (3.7-28.2)] with 8.3% [95% CI (0.5-31.1)] and 0% PFS at 3 and 5 years respectively. Median OS was 43.4 months [95% CI (16.8-60)]. Trial registration Clinical Trials NCT00766142, October 3, 2008. Retrospectively registered.

摘要

目的

这项非随机II期研究的主要目的是评估在完全细胞减灭术(CCS)后采用全身化疗联合西妥昔单抗治疗孤立性结直肠癌腹膜转移癌(CRPC)的疗效。这项多中心、前瞻性II期临床试验在7个国家癌症转诊中心开展,然而在研究招募期间发表的研究表明,西妥昔单抗治疗对KRAS基因突变的患者无效,因此在当前方案中增加了一项排除标准,即排除KRAS基因突变的患者。这对招募产生了重大影响,该研究未达到招募46例患者的必要数量。

结果

14例患者接受了CCS并纳入研究,但1例未提供知情同意书,另1例仅接受了1个周期的化疗,最终符合方案人群中有12例患者可供分析。对于年龄>18岁、经组织学证实为CRPC且无其他转移疾病(肝、肺、淋巴结病等)的患者,在完成CCS后给予辅助性Folfox西妥昔单抗治疗。CRPC的中位指数为5.00(范围:1 - 17)。中位无进展生存期(PFS)为12.3个月[95%置信区间(3.7 - 28.2)],3年和5年的PFS分别为8.3%[95%置信区间(0.5 - 31.1)]和0%。中位总生存期(OS)为43.4个月[95%置信区间(16.8 - 60)]。试验注册:临床试验NCT00766142,2008年10月3日。回顾性注册。

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