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西妥昔单抗联合FOLFOX或CAPEOX一线治疗RAS/BRAF野生型转移性结直肠癌的疗效比较:一项多中心病例对照研究

Comparative efficacy of cetuximab combined with FOLFOX or CAPEOX in first-line treatment of RAS/BRAF wild-type metastatic colorectal cancer: a multicenter case-control study.

作者信息

Xu Chang, Ren Jing, Liu Changqing, Gai Yi, Cheng Xiangyu, Wang Yusheng, Wang Guangyu

机构信息

Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin.

Shanxi Medical University.

出版信息

Anticancer Drugs. 2025 Jun 1;36(5):383-393. doi: 10.1097/CAD.0000000000001697. Epub 2025 Feb 4.

Abstract

FOLFOX combined with cetuximab is a recommended first-line treatment regimen for RAS/BRAF wild-type metastatic colorectal cancer (mCRC). CAPEOX combined with cetuximab differs from the FOLFOX regimen by using oral capecitabine instead of continuous infusion of fluorouracil, offering greater convenience and cost-effectiveness with higher patient acceptance. However, the comparative efficacy of these two regimens remains debatable, necessitating further evidence to explore any differences in their efficacy. This study collected medical records of mCRC patients who were treated with CAPEOX or FOLFOX combined with cetuximab from 1 October 2021 to 16 October 2023 at Harbin Medical University Cancer Hospital and the First Hospital of Shanxi Medical University. Eligible patients were selected based on inclusion criteria and followed up through the hospital's follow-up system and telephone interviews. Kaplan-Meier survival analysis and Cox proportional hazards regression analysis were used to assess patients' progression-free survival (PFS) and overall survival (OS). A total of 71 eligible patients were enrolled in this study; 43 patients received CAPEOX combined with cetuximab (Group A, n  = 43), and 28 patients received FOLFOX combined with cetuximab (Group B, n  = 28). The two groups achieved similar median PFS (mPFS) and median OS (mOS), with mPFS of 18 months and 12 months, respectively ( P  = 0.23), and mOS of 33 months and 20 months, respectively ( P  = 0.21), with no statistically significant differences. The results of this study demonstrated that CAPEOX combined with cetuximab is an equally viable option for first-line treatment of RAS/BRAF wild-type mCRC as FOLFOX combined with cetuximab.

摘要

FOLFOX联合西妥昔单抗是RAS/BRAF野生型转移性结直肠癌(mCRC)推荐的一线治疗方案。CAPEOX联合西妥昔单抗与FOLFOX方案的不同之处在于使用口服卡培他滨而非持续输注氟尿嘧啶,具有更高的便利性和成本效益,患者接受度更高。然而,这两种方案的疗效比较仍存在争议,需要进一步的证据来探究它们疗效的差异。本研究收集了2021年10月1日至2023年10月16日在哈尔滨医科大学附属肿瘤医院和山西医科大学第一医院接受CAPEOX或FOLFOX联合西妥昔单抗治疗的mCRC患者的病历。符合条件的患者根据纳入标准进行选择,并通过医院随访系统和电话访谈进行随访。采用Kaplan-Meier生存分析和Cox比例风险回归分析评估患者的无进展生存期(PFS)和总生存期(OS)。本研究共纳入71例符合条件的患者;43例患者接受CAPEOX联合西妥昔单抗治疗(A组,n = 43),28例患者接受FOLFOX联合西妥昔单抗治疗(B组,n = 28)。两组的中位PFS(mPFS)和中位OS(mOS)相似,mPFS分别为18个月和12个月(P = 0.23),mOS分别为33个月和20个月(P = 0.21),差异无统计学意义。本研究结果表明,CAPEOX联合西妥昔单抗作为RAS/BRAF野生型mCRC一线治疗方案与FOLFOX联合西妥昔单抗同样可行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61db/11969360/60ee8e557ffa/acd-36-383-g001.jpg

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