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肝动脉灌注化疗联合瑞戈非尼治疗晚期结直肠癌:一项真实世界的回顾性研究。

Hepatic arterial infusion chemotherapy plus regorafenib in advanced colorectal cancer: a real-world retrospective study.

机构信息

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education, Beijing), Department of Interventional Therapy, Peking University Cancer Hospital and Institute, Beijing, 100142, China.

Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.

出版信息

BMC Gastroenterol. 2022 Jul 4;22(1):328. doi: 10.1186/s12876-022-02344-4.

Abstract

BACKGROUND

Hepatic arterial infusion chemotherapy delivers the drug directly to the liver. We aim to explore the benefits and tolerability of Hepatic arterial infusion chemotherapy plus regorafenib in advanced colorectal liver metastasis refractory to standard systemic chemotherapy.

METHODS

This study analyzed 47 patients treated with hepatic arterial infusion chemotherapy plus regorafenib after standard systemic oxaliplatin and/or irinotecan in combination with bevacizumab or cetuximab between Jan 2017 and Jun 2020. Regorafenib was given for only 3 weeks in a 4-week cycle.

RESULTS

Among 47 patients, 32 (68%) were males. The median age was 61 (29-75). With a median follow-up of 22.2 months (3.7-50.7 months). Before Hepatic arterial infusion chemotherapy administration in combination with regorafenib, 34 (72.3%) patients previously received ≥ 2 prior lines of systemic therapy and 37 (78.7%)patients previously received targeted biological treatment (anti-VEGF or anti-EGFR, or both). The initial doses of regorafenib were 40 mg/d (n = 1, 2.13%), 80 mg/d (n = 11, 23.43%), 120 mg/d (n = 2, 4.26%), and 160 mg/d (n = 23, 48.94%), while for 24.6% (n = 14) dose was unknown. Median Overall Survival was 22.2 months. Median Progression-Free Survival was 10.8 (95% CI: 9.0-13.7) months. Common Adverse Events were hand-foot skin reaction (12.77%), fatigue (6.38%), vomiting (6.38%), and decreased appetite (6.38%). Only 2 patients discontinued regorafenib due to Adverse Events.

CONCLUSIONS

Regorafenib combined with Hepatic arterial infusion was effective and tolerable in patients with liver predominant metastasis of colorectal cancer. Hence, this therapy can be considered as an alternative for second- or subsequent lines of therapy in patients refractory to standard systemic chemotherapy.

摘要

背景

肝动脉灌注化疗将药物直接输送到肝脏。我们旨在探索肝动脉灌注化疗联合regorafenib 在对标准全身化疗耐药的晚期结直肠癌肝转移中的获益和耐受性。

方法

本研究分析了 2017 年 1 月至 2020 年 6 月期间,47 例接受肝动脉灌注化疗联合regorafenib 治疗的患者,这些患者在标准全身奥沙利铂和/或伊立替康联合贝伐单抗或西妥昔单抗治疗后出现进展。regorafenib 仅在 4 周周期的 3 周内给予。

结果

47 例患者中,32 例(68%)为男性。中位年龄为 61(29-75)岁。中位随访时间为 22.2 个月(3.7-50.7 个月)。在接受肝动脉灌注化疗联合 regorafenib 治疗之前,34 例(72.3%)患者之前接受过≥2 线的全身治疗,37 例(78.7%)患者之前接受过靶向生物治疗(抗血管内皮生长因子或抗表皮生长因子受体,或两者兼有)。regorafenib 的初始剂量为 40mg/d(n=1,2.13%)、80mg/d(n=11,23.43%)、120mg/d(n=2,4.26%)和 160mg/d(n=23,48.94%),而对于 24.6%(n=14),剂量未知。中位总生存期为 22.2 个月。中位无进展生存期为 10.8(95%CI:9.0-13.7)个月。常见的不良反应包括手足皮肤反应(12.77%)、乏力(6.38%)、呕吐(6.38%)和食欲下降(6.38%)。仅有 2 例患者因不良反应停止使用 regorafenib。

结论

regorafenib 联合肝动脉灌注化疗在结直肠癌肝转移为主的患者中是有效且耐受良好的。因此,对于对标准全身化疗耐药的患者,该疗法可以考虑作为二线或二线以上治疗的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/136a/9251933/5e6e84f87c8b/12876_2022_2344_Fig1_HTML.jpg

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