Exploratory pooled analysis evaluating the effect of sequence of biological therapies on overall survival in patients with RAS wild-type metastatic colorectal carcinoma.
Exploratory pooled analysis evaluating the effect of sequence of biological therapies on overall survival in patients with RAS wild-type metastatic colorectal carcinoma.
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DOI：
10.1136/esmoopen-2017-000297
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发表时间：
2018
期刊：
影响因子：
7.3
通讯作者：
Rivera F
中科院分区：
文献类型：
--
作者：
Peeters M;Forget F;Karthaus M;Valladares-Ayerbes M;Zaniboni A;Demonty G;Guan X;Rivera F
本研究的目的是评估针对 RAS 野生型 (WT) 转移性结直肠癌 (mCRC) 患者的靶向治疗（表皮生长因子受体抑制剂 (EGFRi) 和血管内皮生长因子抑制剂 (VEGFi)）联合化疗的最佳顺序。对接受一线帕尼单抗 (EGFRi) 和二线 VEGFi 治疗或一线贝伐单抗 (VEGFi) 和二线 EGFRi 治疗的患者的总生存期 (OS) 进行了探索性分析。分析中包括来自 PEAK (NCT00819780)、PRIME (NCT00364013) 和研究 181 (NCT00339183) 的 RAS WT 或 RAS WT/BRAF WT 肿瘤患者。汇总了接受一线帕尼单抗（PEAK 和 PRIME）或一线贝伐单抗（PEAK 和 181）、随后分别接受二线 VEGFi 或 EGFRi 治疗的患者的 OS 数据。总体而言，纳入了 104 名 RAS WT 患者（n=66 帕尼单抗→VEGFi，n=38 贝伐单抗→EGFRi）。在最终数据分析时，帕尼单抗→VEGFi 组与贝伐珠单抗→EGFRi 组中分别有 63.6% 和 92.1% 的患者死亡；中位 OS 分别为 36.8 个月和 27.8 个月（HR 0.65；95% CI 0.42 至 1.03）。 RAS WT/BRAF WT mCRC 患者的 OS HR 总体为 0.58（95% CI 0.36 至 0.95），左侧肿瘤患者的 OS HR 为 0.56（95% CI 0.30 至 1.04）。尽管数量很少，但这些探索性分析表明，与一线贝伐单抗随后二线 EGFRi 相比，一线帕尼单抗联合化疗随后二线 VEGFi 在 RAS WT 和 RAS WT/BRAF WT mCRC 患者中存在改善 OS 的趋势。需要大型前瞻性随机试验来进一步评估 EGFRi/VEGFi 在 mCRC 中的最佳序列。
The aim of this study was to evaluate the optimal sequence of targeted therapies (epidermal growth factor receptor inhibitors (EGFRi) and vascular endothelial growth factor inhibitors (VEGFi)), combined with chemotherapy, in patients with RAS wild-type (WT) metastatic colorectal carcinoma (mCRC). Exploratory analyses of overall survival (OS) for patients treated with either first-line panitumumab (EGFRi) and second-line VEGFi therapy, or first-line bevacizumab (VEGFi) and second-line EGFRi, were conducted. Patients from PEAK (NCT00819780), PRIME (NCT00364013) and Study 181 (NCT00339183), with RAS WT or RAS WT/BRAF WT tumours, were included in the analyses. OS data were pooled for patients receiving first-line panitumumab (PEAK and PRIME) or first-line bevacizumab (PEAK and 181), followed by second-line VEGFi or EGFRi, respectively. Overall, 104 RAS WT patients were included (n=66 panitumumab→VEGFi, n=38 bevacizumab→EGFRi). At the time of final data analysis, 63.6% versus 92.1% of patients in the panitumumab→VEGFi versus bevacizumab→EGFRi arms had died; median OS was 36.8 versus 27.8 months, respectively (HR 0.65; 95% CI 0.42 to 1.03). The OS HR for patients with RAS WT/BRAF WT mCRC overall was 0.58 (95% CI 0.36 to 0.95) and was 0.56 (95% CI 0.30 to 1.04) in those with left-sided tumours. Although numbers are small, these exploratory analyses suggest a trend towards improved OS for first-line panitumumab plus chemotherapy followed by second-line VEGFi, compared with first-line bevacizumab followed by second-line EGFRi in patients with RAS WT and RAS WT/BRAF WT mCRC. Large prospective randomised trials are needed to further evaluate the optimum sequence of EGFRi/VEGFi in mCRC.
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影响因子：
45.3
作者：
Modest, Dominik P.;Stintzing, Sebastian;Heinemann, Volker
通讯作者：
Heinemann, Volker
DOI：
10.1016/s1470-2045(13)70163-3
发表时间：
2013-07
期刊：
The Lancet. Oncology
影响因子：
--
作者：
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通讯作者：
Quirke P
影响因子：
2.9
作者：
Lam KO;Lee VH;Liu RK;Leung TW;Kwong DL
通讯作者：
Kwong DL
影响因子：
--
作者：
Derangère V;Fumet JD;Boidot R;Bengrine L;Limagne E;Chevriaux A;Vincent J;Ladoire S;Apetoh L;Rébé C;Ghiringhelli F
通讯作者：
Ghiringhelli F
DOI：
10.1001/jama.2017.7105
发表时间：
2017-06-20
期刊：
JAMA
影响因子：
--
作者：
Venook AP;Niedzwiecki D;Lenz HJ;Innocenti F;Fruth B;Meyerhardt JA;Schrag D;Greene C;O'Neil BH;Atkins JN;Berry S;Polite BN;O'Reilly EM;Goldberg RM;Hochster HS;Schilsky RL;Bertagnolli MM;El-Khoueiry AB;Watson P;Benson AB 3rd;Mulkerin DL;Mayer RJ;Blanke C
通讯作者：
Blanke C