Survival of patients with KRAS wild-type metastatic colorectal cancer is identical after sequential treatment with cetuximab and bevacizumab regardless of the sequence - A retrospective single-center study.
Survival of patients with KRAS wild-type metastatic colorectal cancer is identical after sequential treatment with cetuximab and bevacizumab regardless of the sequence - A retrospective single-center study.
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无论顺序如何，KRAS 野生型转移性结直肠癌患者在接受西妥昔单抗和贝伐单抗序贯治疗后，生存率相同 — 一项回顾性单中心研究
DOI：
10.1093/gastro/gov051
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发表时间：
2015-11
影响因子：
3.6
通讯作者：
Hu H
中科院分区：
文献类型：
--
作者：
Deng Y;Cai Y;Lin J;Jiang L;Hu H
目的：探讨KRAS野生型转移性结直肠癌(MCRC)患者在治疗过程中先后接受贝伐单抗和西妥昔单抗治疗后的总体生存情况。方法：对在中山大学胃肠医院接受贝伐单抗和西妥昔单抗治疗的26例mCRC患者进行回顾性分析。A组(n = 8)先接受贝伐单抗治疗，B组(n = 18)先接受西妥昔单抗治疗。比较两组患者的客观有效率、无进展生存率和总生存率。结果：两组患者的基线特征在统计学上相似。A组和B组的客观有效率分别为62.5%和66.6%(P = 0.132)。A组和B组的中位无进展生存期分别为13个月和10个月(P = 0.798)。整个队列患者的中位总生存期分别为42个月、44个月和39个月(P = 0.862)。年龄40岁的患者比≥40岁的患者生存期差(22个月比44个月；P = 0.029)。同时转移患者的存活率低于异时转移患者(未达和36个月)。在多变量分析中，同步转移和年龄仍然具有统计学意义。同步转移的危险比为4.548，年龄为40岁的≥患者的HR为0.237。结论：无论靶向治疗顺序如何，患者的中位生存期都较长，这一点值得进一步研究。
Objective: To investigate the overall survival of patients with KRAS wild-type metastatic colorectal cancer (mCRC) after sequentially receiving both bevacizumab and cetuximab during the course of treatment. Methods: Twenty-six mCRC patients who received both bevacizumab and cetuximab at the Sun Yat-sen University Gastrointestinal Hospital were retrospectively analyzed. Group A (n = 8) comprised patients who received bevacizumab first, and group B (n = 18) comprised those who received cetuximab first. The objective response rate, progression-free survival, and overall survival were compared. Results: Baseline characteristics between the two groups were statistically similar. The objective response in groups A and B patients was 62.5% and 66.6%, respectively (P = 0.132). The median progression-free survival for groups A and B patients was 13 and 10 months, respectively (P = 0.798). The median overall survival for the entire cohort was 42 months, 44 months for group A and 39 months for group p B (P = 0.862) patients, respectively. Patients aged <40 years had worse survival than those aged ≥40 years (22 vs 44 months; P = 0.029). Patients with synchronous metastasis had worse survival than those with metachronous metastasis (unreached and 36 months, respectively). In multivariate analyses, synchronous metastasis and age remained statistically significant. The hazard ratio for synchronous metastasis was 4.548, and the HR for patients aged ≥40 years was 0.237. Conclusion: A longer median survival time was observed in patients regardless of the targeted therapy sequence, which warrants further investigation.