Deng Ting, Duan Jingjing, Bai Ming, Zhang Le, Li Hongli, Liu Rui, Ning Tao, Ge Shaohua, Wang Xia, Yang Yuchong, Ji Zhi, Wang Feixue, Ba Yi
Department of GI Medical Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Huanhu West Road, Tianjin 300060, China.
Department of GI Medical Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.
Ther Adv Chronic Dis. 2023 Sep 13;14:20406223231197311. doi: 10.1177/20406223231197311. eCollection 2023.
There are multiple recommendations on the third-line therapy of metastatic colorectal cancer (mCRC); however, no consensus has been reached.
This study aimed to explore the patient demographics and the real-world third-line treatment landscape of mCRC.
A retrospective real-world cohort study.
Electronic medical records of mCRC patients from Tianjin Medical University Cancer Institute and Hospital between 2013 and 2020 were collected. Upon descriptive, comparative, and survival analyses, a retrospective study was conducted to describe demographics and clinical outcomes of mCRC patients receiving third-line treatment.
Among 218 mCRC patients receiving third-line therapy, 65.5% received chemotherapy combined with or without targeted drugs, followed by anti-angiogenic monotherapy (18.4%), anti-epidermal growth factor receptor drugs (6.9%) and immunotherapy (6.4%). The overall response rate and disease control rate reached 10.2% and 59.2%, respectively; and median progression-free survival (PFS) and overall survival were 4.0 m and 10.7 m, respectively. After Cox multivariate analysis, we found that therapeutic regime was an independent prognostic factor. Compared to patients receiving anti-angiogenic monotherapy, those receiving chemotherapy combined with or without targeted drugs exhibited better prognosis. For patients whose PFS were longer in the front-line treatment, the PFS of third-line therapy was also relatively longer ( = 0.023). Multiple types of therapies (>3, = 0.002) or multiple drugs (>5, = 0.024) in the whole-course management of mCRC are indicators of longer survival.
Chemotherapy combined with or without targeted therapy remained dominated third-line choice and showed favorable efficacy compared with anti-angiogenic monotherapy. With the application of more types and quantities of effective drugs, patients would achieve better survival.
关于转移性结直肠癌（mCRC）的三线治疗有多项建议；然而，尚未达成共识。
本研究旨在探讨mCRC患者的人口统计学特征及真实世界中的三线治疗情况。
一项回顾性真实世界队列研究。
收集2013年至2020年期间天津医科大学肿瘤医院mCRC患者的电子病历。在进行描述性、比较性和生存分析后，开展一项回顾性研究，以描述接受三线治疗的mCRC患者的人口统计学特征和临床结局。
在218例接受三线治疗的mCRC患者中，65.5%接受了化疗联合或不联合靶向药物治疗，其次是抗血管生成单药治疗（18.4%）、抗表皮生长因子受体药物治疗（6.9%）和免疫治疗（6.4%）。总体缓解率和疾病控制率分别达到10.2%和59.2%；中位无进展生存期（PFS）和总生存期分别为4.0个月和10.7个月。经过Cox多因素分析，我们发现治疗方案是一个独立的预后因素。与接受抗血管生成单药治疗的患者相比，接受化疗联合或不联合靶向药物治疗的患者预后更好。对于一线治疗中PFS较长的患者，三线治疗的PFS也相对较长（P = 0.023）。mCRC全程管理中采用多种治疗方式（>3种，P = 0.002）或多种药物（>5种，P = 0.024）是生存期较长的指标。
化疗联合或不联合靶向治疗仍是主要的三线治疗选择，与抗血管生成单药治疗相比显示出良好的疗效。随着更多种类和数量的有效药物的应用，患者将获得更好的生存。
