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卡培他滨联合贝伐珠单抗和外照射放疗作为可切除局部晚期直肠腺癌术前治疗的 II 期随机试验:长期结果。

Phase II randomized trial of capecitabine with bevacizumab and external beam radiation therapy as preoperative treatment for patients with resectable locally advanced rectal adenocarcinoma: long term results.

机构信息

Medical Oncology. Oncobell Program IDIBELL Institut Català d'Oncologia Hospital Duran i Reynals, CIBERONC, Barcelona, Spain.

Medical Oncology, Hospital Universitari Vall d'Hebrón, Barcelona, Spain.

出版信息

BMC Cancer. 2020 Nov 27;20(1):1164. doi: 10.1186/s12885-020-07661-z.

Abstract

BACKGROUND

Preoperative chemoradiotherapy with capecitabine is considered as a standard of care for locally advanced rectal cancer. The "Tratamiento de Tumores Digestivos" group (TTD) previously reported in a randomized Ph II study that the addition of Bevacizumab to capecitabine-RT conferred no differences in the pre-defined efficacy endpoint (pathological complete response). We present the follow-up results of progression-free survival, distant relapse-free survival, and overall survival data at 3 and 5 years.

METHODS

Patients (pts) were randomized to receive 5 weeks of radiotherapy (45 Gy/25 fractions) with concurrent Capecitabine 825 mg/m2 twice daily, 5 days per week with (arm A) or without (arm b) bevacizumab (5 mg/kg once every 2 weeks).

RESULTS

In our study, the addition of bevacizumab to capecitabine and radiotherapy in the neoadjuvant setting shows no differences in pathological complete response (15.9% vs 10.9%), distant relapse-free survival (81.0 vs 80.4 and 76.2% vs 78.2% at 3 and 5 years respectively), disease-free survival (75% vs 71.7 and 68.1% vs 69.57% at 3 and 5 years respectively) nor overall survival at 5-years of follow-up (81.8% vs 86.9%).

CONCLUSIONS

the addition of bevacizumab to capecitabine plus radiotherapy does not confer statistically significant advantages neither in distant relapse-free survival nor in disease-free survival nor in Overall Survival in the short or long term.

TRIAL REGISTRATION

EudraCT number: 2009-010192-24 . Clinicaltrials.gov number: NCT01043484 .

摘要

背景

卡培他滨术前放化疗被认为是局部晚期直肠癌的标准治疗方法。“消化系统肿瘤治疗”(TTD)小组曾在一项随机二期研究中报告,贝伐单抗联合卡培他滨 - RT 治疗并未在预先设定的疗效终点(病理完全缓解)上带来差异。我们报告了无进展生存、远处无复发生存和总生存数据在 3 年和 5 年时的随访结果。

方法

患者随机接受 5 周放疗(45Gy/25 次),同时给予卡培他滨 825mg/m2,每日 2 次,每周 5 天,联合(A 组)或不联合(B 组)贝伐单抗(5mg/kg,每 2 周 1 次)。

结果

在我们的研究中,在新辅助治疗中贝伐单抗联合卡培他滨和放疗在病理完全缓解方面没有差异(15.9%比 10.9%),远处无复发生存(3 年和 5 年时分别为 81.0%比 80.4%和 76.2%比 78.2%),无疾病生存(3 年和 5 年时分别为 75%比 71.7%和 68.1%比 69.57%),也没有在 5 年随访时的总生存(81.8%比 86.9%)。

结论

贝伐单抗联合卡培他滨加放疗在远处无复发生存、无疾病生存或总生存方面没有带来统计学上的显著优势,无论是短期还是长期。

试验注册

EudraCT 编号:2009-010192-24。Clinicaltrials.gov 编号:NCT01043484。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14db/7694337/bc028fb8a80d/12885_2020_7661_Fig1_HTML.jpg

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