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新辅助贝伐单抗联合多西他赛/顺铂/卡培他滨化疗用于局部晚期胃癌患者:一项初步研究

Neoadjuvant Bevacizumab Plus Docetaxel/Cisplatin/Capecitabine Chemotherapy in Locally Advanced Gastric Cancer Patients: A Pilot Study.

作者信息

Yu Deguo, Wang Zhenfeng, He Tingbang, Yang Lijun

机构信息

Department of Emergency Surgery, The Second People's Hospital of Liaocheng, Linqing, China.

Department of General Surgery, The Second People's Hospital of Liaocheng, Linqing, China.

出版信息

Front Surg. 2022 May 11;9:842828. doi: 10.3389/fsurg.2022.842828. eCollection 2022.

Abstract

BACKGROUND

Bevacizumab (BEV) plus chemotherapy as a neoadjuvant regimen presents good efficacy in patients with locally advanced cancer. However, its role in patients with locally advanced gastric cancer (LAGC) is not clear. Thus, the study aimed to assess the efficacy and safety of neoadjuvant BEV plus chemotherapy in patients with LAGC.

METHODS

Twenty resectable patients with LAGC who received BEV plus docetaxel/cisplatin/capecitabine (DCC) chemotherapy for 3 cycles with 21 days as one cycle as neoadjuvant regimen were involved. Besides, their treatment response, survival profiles, and adverse events were assessed.

RESULTS

In total, two (10.0%), 9 (45.0%), 8 (40.0%), and 1 (5.0%) patients achieved complete remission, partial remission, stable disease, and progressive disease (PD) according to imaging evaluation, which resulted in 55.0% of objective response rate and 95.0% of disease control rate, respectively. Moreover, the number of patients with pathological response grades 1, 2, and 3 was 8 (40.0%), 8 (40.0%), and 3 (15.0%); while 1 (5.0%) patient did not receive surgery due to PD, thus the data of this patient was not assessable. Meanwhile, 18 (90.0%) patients achieved R0 resection. Regarding survival profile, the median disease-free survival or overall survival were both not reached. The 1-year, 2-, and 3-year disease-free survival rates were 88.8, 80.7, and 67.3%. Meanwhile, the 1-, 2-, and 3-year overall survival rates were 100.0%, 75.8%, and 75.8%, respectively. Additionally, the main adverse events were anemia (90.0%), alopecia (90.0%), leukopenia (70.0%), and anorexia (65.0%). Indeed, most adverse events were of grade 1 or 2 and were manageable.

CONCLUSION

Neoadjuvant BEV plus DCC chemotherapy presents a favorable pathological response and survival profile with acceptable safety in patients with LAGC.

摘要

背景

贝伐单抗(BEV)联合化疗作为新辅助治疗方案在局部晚期癌症患者中显示出良好疗效。然而,其在局部晚期胃癌(LAGC)患者中的作用尚不清楚。因此,本研究旨在评估新辅助BEV联合化疗在LAGC患者中的疗效和安全性。

方法

纳入20例可切除的LAGC患者,接受BEV联合多西他赛/顺铂/卡培他滨(DCC)化疗,每21天为1个周期,共3个周期作为新辅助治疗方案。此外,评估他们的治疗反应、生存情况和不良事件。

结果

根据影像学评估,总共2例(10.0%)、9例(45.0%)、8例(40.0%)和1例(5.0%)患者分别达到完全缓解、部分缓解、疾病稳定和疾病进展(PD),客观缓解率和疾病控制率分别为55.0%和95.0%。此外,病理反应1级、2级和3级的患者数量分别为8例(40.0%)、8例(40.0%)和3例(15.0%);而1例(5.0%)患者因疾病进展未接受手术,因此该患者的数据不可评估。同时,18例(90.0%)患者实现了R0切除。关于生存情况,无病生存期或总生存期的中位数均未达到。1年、2年和3年无病生存率分别为88.8%、80.7%和67.3%。同时,1年、2年和3年总生存率分别为100.0%、75.8%和75.8%。此外,主要不良事件为贫血(90.0%)、脱发(90.0%)、白细胞减少(70.0%)和厌食(65.0%)。实际上,大多数不良事件为1级或2级,且可控制。

结论

新辅助BEV联合DCC化疗在LAGC患者中呈现出良好的病理反应和生存情况,安全性可接受。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2603/9130594/cba5e55d323b/fsurg-09-842828-g0001.jpg

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