Medical Department I, University Cancer Center, University Hospital Carl Gustav Carus, Dresden, Germany.
Department of Precision Medicine, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy.
Cancer Treat Rev. 2022 Jan;102:102301. doi: 10.1016/j.ctrv.2021.102301. Epub 2021 Nov 11.
Doublet or triplet chemotherapy regimens in combination with anti-epidermal growth factor receptor (anti-EGFR) monoclonal antibodies (mAb), such as cetuximab or panitumumab, or the anti-vascular endothelial growth factor mAb bevacizumab, are the current recommended standard of care therapies for unresectable metastatic colorectal cancer (mCRC). While the recommended dosing schedule for the triplet chemotherapy regimen with 5-fluorouracil, oxaliplatin and irinotecan (FOLFOXIRI) in combination with bevacizumab is well established, the optimal dosing of FOLFOXIRI in combination with anti-EGFR agents is unknown. Several randomized, phase 3 clinical trials of patients with mCRC have demonstrated improved survival and response rates with FOLFOXIRI, alone or when combined with bevacizumab, compared with doublet chemotherapy regimens. Trials of anti-EGFR agents in combination with FOLFOXIRI have also shown promising results. In this review, we summarize the emerging evidence regarding the safety and efficacy of anti-EGFR agents in combination with triplet chemotherapy regimens and discuss the potential for this combination as a future treatment option for patients with RAS-wild-type mCRC.
联合抗表皮生长因子受体（anti-EGFR）单克隆抗体（mAb）如西妥昔单抗或帕尼单抗，或抗血管内皮生长因子 mAb 贝伐珠单抗的双联或三联化疗方案是目前不可切除转移性结直肠癌（mCRC）的标准治疗推荐方案。虽然联合贝伐珠单抗的三联化疗方案（5-氟尿嘧啶、奥沙利铂和伊立替康[FOLFOXIRI]）的推荐剂量方案已经确立，但联合抗 EGFR 药物的 FOLFOXIRI 的最佳剂量尚不清楚。几项随机、III 期临床试验表明，与双联化疗方案相比，FOLFOXIRI 单药或联合贝伐珠单抗治疗 mCRC 可提高生存率和缓解率。联合 FOLFOXIRI 的抗 EGFR 药物的试验也显示出了有希望的结果。在这篇综述中，我们总结了关于联合三联化疗方案使用抗 EGFR 药物的安全性和疗效的新证据，并讨论了该联合方案作为 RAS 野生型 mCRC 患者未来治疗选择的潜力。
