Department of Hepatobiliary Surgery, The First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, China.
Department of Oncology, Shibei Hospital of Shanghai, No. 4500, Goughexin Road, Jing' an District, Shanghai, 200443, China.
BMC Cancer. 2021 Jan 7;21(1):30. doi: 10.1186/s12885-020-07770-9.
An upgraded understanding of factors (sex/estrogen) associated with survival benefit in advanced colorectal carcinoma (CRC) could improve personalised management and provide innovative insights into anti-tumour mechanisms. The aim of this study was to assess the efficacy and safety of cetuximab (CET) versus bevacizumab (BEV) following prior 12 cycles of fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) plus BEV in postmenopausal women with advanced KRAS and BRAF wild-type (wt) CRC.
Prospectively maintained databases were reviewed from 2013 to 2017 to assess postmenopausal women with advanced KRAS and BRAF wt CRC who received up to 12 cycles of FOLFOXIRI plus BEV inductive treatment, followed by CET or BEV maintenance treatment. The primary endpoints were overall survival (OS), progression-free survival (PFS), response rate. The secondary endpoint was the rate of adverse events (AEs).
At a median follow-up of 27.0 months (IQR 25.1-29.2), significant difference was detected in median OS (17.7 months [95% confidence interval [CI], 16.2-18.6] for CET vs. 11.7 months [95% CI, 10.4-12.8] for BEV; hazard ratio [HR], 0.63; 95% CI, 0.44-0.89; p=0.007); Median PFS was 10.7 months (95% CI, 9.8-11.3) for CET vs. 8.4 months (95% CI, 7.2-9.6) for BEV (HR, 0.67; 95% CI 0.47-0.94; p=0.02). Dose reduction due to intolerable AEs occurred in 29 cases (24 [24.0%] for CET vs. 5 [4.8%] for BEV; p< 0.001).
CET tends to be superior survival benefit when compared with BEV, with tolerated AEs.
对晚期结直肠癌（CRC）中与生存获益相关的因素（性别/雌激素）的认识不断提高，这可以改善个体化管理，并为抗肿瘤机制提供新的见解。本研究的目的是评估西妥昔单抗（CET）与贝伐珠单抗（BEV）在绝经后妇女中应用于先前接受 12 周期氟尿嘧啶、亚叶酸钙、奥沙利铂和伊立替康（FOLFOXIRI）加 BEV 诱导治疗后，治疗 KRAS 和 BRAF 野生型（wt）晚期 CRC 的疗效和安全性。
从 2013 年到 2017 年，对前瞻性维护的数据库进行了回顾性评估，以评估接受最多 12 周期 FOLFOXIRI 加 BEV 诱导治疗后，KRAS 和 BRAF wt 晚期 CRC 的绝经后妇女，随后接受 CET 或 BEV 维持治疗。主要终点是总生存期（OS）、无进展生存期（PFS）、反应率。次要终点是不良事件（AE）的发生率。
中位随访 27.0 个月（IQR 25.1-29.2）时，CET 的中位 OS 显著长于 BEV（17.7 个月[95%置信区间（CI），16.2-18.6]vs. 11.7 个月[95%CI，10.4-12.8]；风险比[HR]，0.63；95%CI，0.44-0.89；p=0.007）；CET 的中位 PFS 长于 BEV（10.7 个月[95%CI，9.8-11.3]vs. 8.4 个月[95%CI，7.2-9.6]；HR，0.67；95%CI 0.47-0.94；p=0.02）。由于不耐受的 AE 而减少剂量的情况发生在 29 例（CET 组 24 例[24.0%]，BEV 组 5 例[4.8%]；p<0.001）。
与 BEV 相比，CET 具有更好的生存获益，且 AE 可耐受。
