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抗表皮生长因子受体(EGFR)在老年转移性结直肠癌治疗中作用的最新进展

An Update on the Role of Anti-EGFR in the Treatment of Older Patients with Metastatic Colorectal Cancer.

作者信息

Rosati Gerardo, Montrone Michele, Pacilio Carmen, Colombo Alfredo, Cicero Giuseppe, Paragliola Fernando, Vaia Angelo, Annunziata Luigi, Bilancia Domenico

机构信息

Medical Oncology Unit, "San Carlo" Hospital, 85100 Potenza, Italy.

Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", 70124 Bari, Italy.

出版信息

J Clin Med. 2022 Nov 30;11(23):7108. doi: 10.3390/jcm11237108.

Abstract

Although colorectal cancer is increasingly being diagnosed in older patients, their number is largely underrepresented in phase II or III clinical trials. Consequently, guidelines and the SIOG recommendations are not sufficiently clear regarding the treatment of these patients, particularly when chemotherapy is combined with monoclonal antibodies (bevacizumab, cetuximab, and panitumumab). Targeted therapy based on the use of anti-epidermal growth factor receptors (EGFRs) is conditioned by the potential for increased toxicity, making it more difficult to treat an older, rat sarcoma virus (RAS) and B rapidly accelerated fibrosarcoma (BRAF) wild-type patient. In light of a more detailed characterization of the older population, modernly differentiable between fit, vulnerable, or frail patients on the basis of the comprehensive geriatric assessment, and of the analysis of more recent studies, this review fully collects data from the literature, differentiating the results on functional status patients.

摘要

尽管老年患者中结直肠癌的诊断率日益提高,但在II期或III期临床试验中,老年患者的数量在很大程度上未得到充分体现。因此,关于这些患者的治疗,指南和国际老年肿瘤学会(SIOG)的建议不够明确,尤其是当化疗与单克隆抗体(贝伐单抗、西妥昔单抗和帕尼单抗)联合使用时。基于抗表皮生长因子受体(EGFR)的靶向治疗因毒性增加的可能性而受到限制,这使得治疗年龄较大、鼠肉瘤病毒(RAS)和B型快速进展性纤维肉瘤(BRAF)野生型患者变得更加困难。鉴于对老年人群的更详细特征描述,根据综合老年评估以及对近期研究的分析,现代医学能够区分健康、脆弱或体弱的患者,本综述全面收集了文献数据,区分了功能状态患者的结果。

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