Kimura Keisuke, Katata Yosuke, Umeda Yuzo, Tanaka Takehiro, Yano Shuya, Yoshida Kazuhiro, Fujiwara Toshiyoshi, Mori Yoshiko, Yamada Takeshi, Nagasaka Takeshi
Department of Gastroenterological Surgery, Okayama University Hospital, Okayama 700-8558, Japan.
Department of Clinical Oncology, Kawasaki Medical School Hospital, Kurashiki, Okayama 701-0192, Japan.
Oncol Lett. 2024 Jul 15;28(3):439. doi: 10.3892/ol.2024.14572. eCollection 2024 Sep.
The present study investigated the role of ramucirumab (RAM) in treating liver metastases (LMs) as a second-line or salvage treatment in patients with advanced CRC. Of the 36 patients, 21 (58%) received RAM plus folinic acid, fluorouracil and irinotecan (FOLFIRI) as second-line treatment, whereas 15 (42%) received it in a salvage setting. The median overall survival time was 23 months [95% confidence interval (CI), 12-34 months] for those in the second-line treatment group and 8 months (95% CI, 5-19 months) for those in the salvage treatment group. Of the 36 patients, 14 (39%) underwent surgical resection of LMs during chemotherapy. A total of 6 patients underwent surgical resection for LMs for the first time during second-line RAM plus FOLFIRI (RAM-LM); of the remaining 8 patients, 6 underwent resection of LMs during first-line bevacizumab (BEV)-based chemotherapy (BEV-LM). Immunohistochemical analysis of CD42b showed that the platelet aggregation score (CD42b score), which ranges from 0 (absence of deposition) to 3 (presence of linear deposition), tended to decrease with the increasing duration of treatment with both RAM and BEV. Although there was no significant difference in the mean duration of anti-VEGF antibody treatment between the BEV-LM and RAM-LM groups, the median CD42b score was higher in the RAM-LM group (median CD42b score, 3; range, 0-3) compared with that in the BEV-LM group (median CD42b score, 1; range, 0-3; P=0.01), suggesting that RAM induces a different degree of platelet aggregation in liver sinusoids compared to BEV.
本研究调查了雷莫西尤单抗（RAM）在晚期结直肠癌患者中作为二线或挽救治疗方案治疗肝转移（LM）的作用。36例患者中，21例（58%）接受RAM联合亚叶酸、氟尿嘧啶和伊立替康（FOLFIRI）作为二线治疗，而15例（42%）在挽救治疗中接受该方案。二线治疗组患者的中位总生存时间为23个月[95%置信区间（CI），12 - 34个月]，挽救治疗组为8个月（95%CI，5 - 19个月）。36例患者中，14例（39%）在化疗期间接受了肝转移灶的手术切除。共有6例患者在二线RAM联合FOLFIRI（RAM - LM）治疗期间首次接受肝转移灶的手术切除；其余8例患者中，6例在一线基于贝伐单抗（BEV）的化疗期间接受了肝转移灶的切除（BEV - LM）。CD42b的免疫组化分析显示，血小板聚集评分（CD42b评分）范围为0（无沉积）至3（有线状沉积），随着RAM和BEV治疗时间的延长均有下降趋势。虽然BEV - LM组和RAM - LM组抗VEGF抗体治疗的平均持续时间无显著差异，但RAM - LM组的中位CD42b评分高于BEV - LM组（RAM - LM组中位CD42b评分为3；范围为0 - 3；BEV - LM组中位CD42b评分为1；范围为0 - 3；P = 0.01），这表明与BEV相比，RAM在肝窦中诱导的血小板聚集程度不同。
