First-line cetuximab improves the efficacy of subsequent bevacizumab for RAS wild-type left-sided metastatic colorectal cancer: an observational retrospective study
First-line cetuximab improves the efficacy of subsequent bevacizumab for RAS wild-type left-sided metastatic colorectal cancer: an observational retrospective study
复制标题
DOI：
10.1038/s41598-020-69230-5
复制
发表时间：
2020-07-23
影响因子：
4.6
通讯作者：
Xia, Liangping
中科院分区：
文献类型：
--
作者：
Liu, Shousheng;Jiang, Chang;Xia, Liangping
RAS野生型左侧转移性结直肠癌（mCRC）患者的最佳靶向治疗序列仍存在争议，很少有研究关注一线靶向药物对二线靶向药物的影响。我们入组了101例RAS野生型状态的左侧mCRC患者，其中50例接受贝伐珠单抗联合一线和二线化疗（A组），51例接受一线西妥昔单抗联合化疗，随后接受含贝伐珠单抗的二线方案（B组）。比较两组患者从一线治疗（PFS 1 nd和OS 1 nd）和二线治疗（PFS 2nd和OS 2nd）开始的无进展生存期（PFS）和总生存期（OS）。与B组相比，A组的第1次PFS相当（10.0 vs 10.4个月; p=0.402），而第2次PFS（4.6 vs 7.9个月; p=0.002）、第1次OS（26.8 vs 40.0个月; p=0.011）和第2次OS（15.2 vs 22.3个月; p=0.006）均较差。我们的研究结合既往临床数据提示，西妥昔单抗一线应用可能为后续贝伐珠单抗的疗效提升提供有利条件，因此代表RAS野生型左侧mCRC患者的最佳靶向治疗序列。
The optimal targeted therapy sequence in patients of RAS wild-type left-sided metastatic colorectal cancer (mCRC) remains controversial, and few studies focus on the impact of first-line targeted agents on second-line ones. We enrolled 101 left-sided mCRC patients with RAS wild-type status, of which 50 cases received bevacizumab plus chemotherapy in both first-line and second-line therapies (Group A) and 51 cases received first-line cetuximab plus chemotherapy followed by second-line bevacizumab-containing regimens (Group B). The progression free survival (PFS) and overall survival (OS) from start of first-line (PFS 1nd and OS 1nd) and second-line (PFS 2nd and OS 2nd) therapy were compared between the two groups. PFS 1nd was comparable (10.0 vs 10.4 months; p=0.402), while PFS 2nd (4.6 vs 7.9 months; p=0.002), OS 1nd (26.8 vs 40.0 months; p=0.011), and OS 2nd (15.2 vs 22.3 months; p=0.006) were all poorer in group A compared with group B. Our study in combination with previous clinical data suggest that first-line application of cetuximab may provide a favorable condition for promoting the effect of subsequent bevacizumab, thus representing the optimal targeted therapy sequence in patients of RAS wild-type left-sided mCRC.