Li Yong, Chen Xian, Li Wenzhu, Ye Yongsong, Du Xiaohua, Sun Shaodan, Liu Lirong, Zhang Haibo
Department of Oncology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
Department of Image, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
Front Oncol. 2021 May 24;11:684309. doi: 10.3389/fonc.2021.684309. eCollection 2021.
The standard third-line treatment of metastatic colorectal cancer (mCRC) includes the small-molecule anti-vascular drugs (Regofenib and Fruquintinib) and the chemotherapy drug trifluridine and tipiracil hydrochloride (TAS-102). There is no standard treatment for mCRC if the third-line treatment failed. Therefore, it is a pressing need to develop new therapeutic approaches to improve the survival of patients who developed drug resistance to the third-line treatment. In this study, we report a case of mCRC with RAS/BRAF wild-type, who was successfully treated using cetuximab in combination with fruquintinib after resistance to chemotherapy, bevacizumab, cetuximab and regorafenib. This patient responded to this combination regimen. Then, we discuss the mechanisms of action of this combination. Furthermore, we introduce the clinical trials on the combination regimens of anti-EGFR with anti-vascular monoclonal antibodies. Finally, we discuss the clinical explorations of using combination of anti-EGFR with small-molecule anti-VEGF drugs and their potential benefits. The clinical effects of small-molecule anti-vascular drugs in combination with anti-EGFR in the treatment of CRC warrant further explored.
转移性结直肠癌（mCRC）的标准三线治疗包括小分子抗血管生成药物（瑞戈非尼和呋喹替尼）以及化疗药物曲氟尿苷替匹嘧啶（TAS-102）。如果三线治疗失败，mCRC就没有标准治疗方案。因此，迫切需要开发新的治疗方法，以提高对三线治疗产生耐药性患者的生存率。在本研究中，我们报告了1例RAS/BRAF野生型mCRC患者，该患者在对化疗、贝伐单抗、西妥昔单抗和瑞戈非尼耐药后，使用西妥昔单抗联合呋喹替尼成功治疗。该患者对这种联合治疗方案有反应。然后，我们讨论了这种联合治疗的作用机制。此外，我们介绍了抗表皮生长因子受体（EGFR）与抗血管生成单克隆抗体联合治疗方案的临床试验。最后，我们讨论了使用抗EGFR与小分子抗血管内皮生长因子（VEGF）药物联合治疗的临床探索及其潜在益处。小分子抗血管生成药物与抗EGFR联合治疗结直肠癌的临床效果值得进一步探索。
