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西妥昔单抗治疗RAS和BRAF野生型不可切除转移性结直肠癌的两阶段维持试验:一项回顾性真实世界研究

A two-stage maintenance trial of cetuximab-based treatment in RAS and BRAF wild-type unresectable metastatic colorectal cancer: a retrospective real-world study.

作者信息

Jiang Tao, Chen Hao, Wang Xinli, Lin Fangyu, Wang Han, Liu Jialin, Lin Xiaoyan

机构信息

Department of Medical Oncology, Fujian Medical University Union Hospital, Fuzhou, China.

Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, China.

出版信息

Front Oncol. 2024 Jul 23;14:1425203. doi: 10.3389/fonc.2024.1425203. eCollection 2024.

Abstract

BACKGROUND

To investigate the effectiveness and safety of maintenance regimens based on cetuximab, we conducted a real-world, single-arm, retrospective study at a single center.

METHODS

In Fujian Medical University Union Hospital, patients with unresectable metastatic colorectal cancer (mCRC) who received cetuximab-based maintenance therapy between December 2020 and December 2021 were included. All patients had RAS and BRAF wild-type. The maintenance regimen consisted of 6-12 cycles of cetuximab plus irinotecan (Phase 1) and cetuximab (Phase 2). Patients could receive reintroduction therapy in case of disease progression during Phase 2. Progression-free survival (PFS), overall survival (OS), and safety data were collected.

RESULTS

According to the inclusion and exclusion criteria of the study, a total of 108 subjects who received maintenance therapy were included- 51 experienced disease progression during Phase 1, with PFS (1) of 7.3 months. Among the 52 patients who entered Phase 2, 17 were still in this phase at the end of follow-up, with PFS (2) of 10.1 months. In Phase 2, 35 patients experienced disease progression, of whom 24 received reintroduction therapy, with PFS (3) of 6.7 months. The overall PFS (total) during the maintenance period was 11.9 months, and the OS was 39.2 months. Grade III or higher adverse events were 4.6% during Phase 1 and 0% during Phase 2.

CONCLUSION

Innovative cetuximab-based maintenance therapy showed a trend toward improving the prognosis of mCRC patients with RAS and BRAF wild-type, while the toxic side effects of maintenance therapy were manageable.

CLINICAL TRIAL REGISTRATION

https://www.chictr.org.cn, identifier ChiCTR2000040940.

摘要

背景

为了研究基于西妥昔单抗的维持治疗方案的有效性和安全性,我们在一个中心开展了一项真实世界、单臂、回顾性研究。

方法

在福建医科大学附属协和医院,纳入了2020年12月至2021年12月期间接受基于西妥昔单抗维持治疗的不可切除转移性结直肠癌(mCRC)患者。所有患者RAS和BRAF均为野生型。维持治疗方案包括6 - 12周期的西妥昔单抗联合伊立替康(第1阶段)和西妥昔单抗(第2阶段)。在第2阶段疾病进展的患者可接受再引入治疗。收集无进展生存期(PFS)、总生存期(OS)和安全性数据。

结果

根据研究的纳入和排除标准,共纳入108例接受维持治疗的受试者,51例在第1阶段出现疾病进展,第1阶段的PFS为7.3个月。在进入第2阶段的52例患者中,17例在随访结束时仍处于该阶段,第2阶段的PFS为10.1个月。在第2阶段,35例患者出现疾病进展,其中24例接受了再引入治疗,第3阶段的PFS为6.7个月。维持期的总体PFS(总计)为11.9个月,OS为39.2个月。第1阶段3/4级不良事件发生率为4.6%,第2阶段为0%。

结论

创新的基于西妥昔单抗的维持治疗显示出改善RAS和BRAF野生型mCRC患者预后的趋势,同时维持治疗的毒副作用可控。

临床试验注册

https://www.chictr.org.cn,标识符ChiCTR2000040940

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0f4/11300202/d8525dcc5cd4/fonc-14-1425203-g001.jpg

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