西妥昔单抗对比贝伐珠单抗维持治疗用于既往接受 8 周期改良 FOLFOXIRI 加西妥昔单抗治疗的亚洲绝经后 KRAS 和 BRAF 野生型转移性结直肠癌患者。
Cetuximab versus bevacizumab maintenance following prior 8-cycle modified FOLFOXIRI plus cetuximab in Asian postmenopausal women with treatment-naive KRAS and BRAF wild-type metastatic colorectal cancer.
机构信息
Department of Hepatobiliary Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Critical Care Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
出版信息
J Int Med Res. 2020 Sep;48(9):300060520930440. doi: 10.1177/0300060520930440.
OBJECTIVE
To assess the efficacy and safety of cetuximab (CE) versus bevacizumab (BE) maintenance treatment after prior 8-cycle modified 5-fluorouracil, folinate, oxaliplatin, and irinotecan (FOLFOXIRI) plus CE induction therapy in treatment-naive KRAS and BRAF wild-type (wt) metastatic colorectal cancer (mCRC).
METHODS
From 2012 to 2017, prospectively maintained databases were reviewed to assess Asian postmenopausal women with treatment-naive KRAS and BRAF wt mCRC who underwent modified FOLFOXIRI plus CE induction therapy, followed by CE or BE maintenance until disease progression or death. Co-primary clinical endpoints were progression-free survival (PFS) and overall survival (OS).
RESULTS
A total of 222 women were included (CE n = 110 and BE n = 112). At a median follow-up of 27.0 months (interquartile range, 6.5-38.6 months), median PFS was 21.9 months (95% confidence interval [CI] 16.4-24.4) and 17.7 months (95% CI 11.3-19.0) for CE and BE groups, respectively (hazard ratio [HR] 0.31, 95% CI 0.15-0.46); median OS was 26.0 months (95% CI 23.4-28.7) and 22.7 months (95% CI 21.2-24.3) for CE and BE groups, respectively (HR 0.22, 95% CI 0.11-0.37).
CONCLUSIONS
CE maintenance treatment is more poorly tolerated but has a slightly more modest survival benefit compared with BE maintenance treatment in mCRC.
目的
评估西妥昔单抗（CE）与贝伐珠单抗（BE）维持治疗在先前接受 8 周期改良氟尿嘧啶、亚叶酸、奥沙利铂和伊立替康（FOLFOXIRI）联合 CE 诱导治疗后，在治疗初治 KRAS 和 BRAF 野生型（wt）转移性结直肠癌（mCRC）中的疗效和安全性。
方法
回顾 2012 年至 2017 年前瞻性维护的数据库，评估接受改良 FOLFOXIRI 联合 CE 诱导治疗，随后接受 CE 或 BE 维持治疗至疾病进展或死亡的治疗初治 KRAS 和 BRAF wt mCRC 的亚洲绝经后女性。主要临床终点为无进展生存期（PFS）和总生存期（OS）。
结果
共纳入 222 例女性（CE 组 n=110，BE 组 n=112）。中位随访 27.0 个月（四分位距 6.5-38.6 个月）时，CE 组和 BE 组的中位 PFS 分别为 21.9 个月（95%置信区间 [CI] 16.4-24.4）和 17.7 个月（95% CI 11.3-19.0）（风险比 [HR] 0.31，95% CI 0.15-0.46）；CE 组和 BE 组的中位 OS 分别为 26.0 个月（95% CI 23.4-28.7）和 22.7 个月（95% CI 21.2-24.3）（HR 0.22，95% CI 0.11-0.37）。
结论
CE 维持治疗耐受性较差，但与 BE 维持治疗相比，mCRC 的生存获益略高。
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