A Review of Clinical Studies and Practical Guide for the Administration of Triplet Chemotherapy Regimens with Bevacizumab in First-line Metastatic Colorectal Cancer.
A Review of Clinical Studies and Practical Guide for the Administration of Triplet Chemotherapy Regimens with Bevacizumab in First-line Metastatic Colorectal Cancer.
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DOI：
10.1007/s11523-015-0400-y
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发表时间：
2016-06
影响因子：
5.4
通讯作者：
Österlund P
中科院分区：
文献类型：
--
作者：
Loupakis F;Stein A;Ychou M;Hermann F;Salud A;Österlund P
结直肠癌是全球第三大常见癌症。相当比例的患者在原发肿瘤手术切除后出现不可切除的转移性疾病或发生异时性转移。在过去的二十年中，随着多模式治疗方案的扩展和化疗方案的日益强化（现在通常包括靶向生物制剂）的发展，该疾病的预后有所改善。最近的治疗进展是由三种化疗药物（即三联化疗：5-氟尿嘧啶[5-FU]/亚叶酸钙[LV]、奥沙利铂和伊立替康；FOLFOXIRI）联合血管内皮生长因子抑制剂贝伐单抗组成的治疗方案。与5-FU/LV和伊立替康联合贝伐单抗相比，该方案已被证明可显著提高客观缓解率和中位无进展生存期。然而，三联化疗与化疗相关不良事件发生率增加有关，治疗中出现的不良事件应得到妥善管理，以尽量减少治疗中断或停止。我们在此回顾了评估FOLFOXIRI联合贝伐单抗治疗转移性结直肠癌的安全性和有效性的临床研究，并提出了与该方案相关的不良事件管理的实用指南。
Colorectal cancer is the third most common cancer worldwide. A significant proportion of patients presents with unresectable metastatic disease or develops metachronous metastases following surgical resection of the primary tumor. The prognosis of the disease has improved over the past two decades, with extended multimodality treatment options and the development of increasingly intensified chemotherapy regimens that now typically include targeted biologics. A recent advance in therapy is a treatment regimen composed of three chemotherapeutic agents (i.e., triplet chemotherapy: 5-fluorouracil [5-FU]/leucovorin [LV], oxaliplatin, and irinotecan; FOLFOXIRI) in combination with the vascular endothelial growth factor inhibitor bevacizumab. This regimen has been shown to elicit significantly improved objective response rates and median progression-free survival compared with 5-FU/LV and irinotecan in combination with bevacizumab. However, triplet chemotherapy has been associated with increased rates of chemotherapy-related adverse events, and treatment-emergent adverse events should be properly managed to minimize treatment interruption or discontinuation. We present herein a review of clinical studies evaluating the safety and efficacy of FOLFOXIRI with bevacizumab in metastatic colorectal cancer, and propose a practical guide for the management of adverse events associated with the regimen.