Bevacizumab plus FOLFIRI or FOLFOX as third-line or later treatment in patients with metastatic colorectal cancer after failure of 5-fluorouracil, irinotecan, and oxaliplatin: a retrospective analysis
Bevacizumab plus FOLFIRI or FOLFOX as third-line or later treatment in patients with metastatic colorectal cancer after failure of 5-fluorouracil, irinotecan, and oxaliplatin: a retrospective analysis
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DOI：
10.1007/s12032-008-9077-8
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发表时间：
2009-03-01
期刊：
影响因子：
3.4
通讯作者：
Lee, Jung Shin
中科院分区：
文献类型：
--
作者：
Kang, Byung Woog;Kim, Tae Won;Lee, Jung Shin
贝伐单抗是一种抗血管内皮生长因子的单克隆抗体，在转移性结直肠癌患者中作为一线或二线治疗已显示出临床活性。在本研究中，我们评估了贝伐单抗联合FOLFIRI（伊立替康、5-氟尿嘧啶和亚叶酸钙）或FOLFOX（奥沙利铂、5-氟尿嘧啶和亚叶酸钙）治疗转移性结直肠癌患者在FOLFIRI和FOLFOX治疗失败后的疗效和安全性。回顾性分析了2004年10月至2007年2月间42例经FOLFIRI和FOLFOX治疗失败的转移性结直肠癌患者的资料。所有患者均接受贝伐单抗联合FOLFIRI或FOLFOX治疗。患者年龄中位数为57.0岁。27例（64.3%）患者ECOG表现状态为0或1。在35名患者（83.3%）中，既往化疗方案的数量为千分之一。39例患者可评估反应。4例患者部分缓解（pr），没有患者完全缓解（CR），总缓解率为9.5%。病情稳定22例（52.4%），病情进展13例（31.0%）。中位随访时间为12.9个月（1.0-30.0个月），中位无进展生存期和中位总生存期分别为5.3个月和9.5个月。18例（42.9%）患者出现3级或4级中性粒细胞减少，包括4例（9.5%）发热性中性粒细胞减少。常见的非血液学毒性是疲劳（21.4%）、神经病变（21.4%）和粘膜炎（21.4%）。2级或3级高血压4例（9.6%），1级或2级蛋白尿16例（38.1%）。与BV相关的不良事件发生频率，如出血、血栓形成和胃肠道穿孔，均在以往报道的范围内。然而，没有与治疗相关的死亡。贝伐单抗联合FOLFIRI或FOLFOX显示出适度的活性，并且在对FOLFIRI和FOLFOX均难治的转移性结直肠癌患者中相对耐受。
Bevacizumab, a monoclonal antibody against vascular endothelial growth factor, has shown clinical activity in metastatic colorectal cancer patients when used as either a first-line or second-line treatment. Here, we evaluated the efficacy and safety of bevacizumab plus FOLFIRI (irinotecan, 5-fluorouracil, and leucovorin) or FOLFOX (oxaliplatin, 5-fluorouracil, and leucovorin) in metastatic colorectal cancer cases after failure to FOLFIRI and FOLFOX. Between October 2004 and February 2007, the data on 42 patients with metastatic colorectal cancer after failure of FOLFIRI and FOLFOX were reviewed retrospectively. All patients were treated with bevacizumab plus FOLFIRI or FOLFOX. The median patient age was 57.0 years. The ECOG performance status was 0 or 1 in 27 patients (64.3%). The number of previous chemotherapy regimens was a parts per thousand yen3 in 35 patients (83.3%). Thirty-nine patients were evaluable for response. Four patients had partial responses (PRs) and no patient had a complete response (CR), giving an overall response rate of 9.5%. Twenty-two patients (52.4%) had stable disease and 13 patients (31.0%) showed progressive disease. With a median follow-up time of 12.9 months (range 1.0-30.0 months), the median progression-free survival time and the median overall survival time were 5.3 and 9.5 months, respectively. Grade 3 or 4 neutropenia developed in 18 patients (42.9%), including febrile neutropenia in 4 patients (9.5%). Common non-hematologic toxicities were fatigue (21.4%), neuropathy (21.4%), and mucositis (21.4%). Grade 2 or 3 hypertension occurred in 4 patients (9.6%), and grade 1 or 2 proteinuria was seen in 16 patients (38.1%). The frequencies of adverse events related BV, such as bleeding, thrombosis, and gastrointestinal perforation, were within the ranges of previous reports. However, there were no treatment-related deaths. The combination of bevacizumab plus FOLFIRI or FOLFOX showed modest activity and was relatively tolerable in patients with metastatic colorectal cancer refractory to both FOLFIRI and FOLFOX.