Chemotherapy plus bevacizumab versus chemotherapy plus cetuximab as first-line treatment for patients with metastatic colorectal cancer: Results of a registry-based cohort analysis.
Chemotherapy plus bevacizumab versus chemotherapy plus cetuximab as first-line treatment for patients with metastatic colorectal cancer: Results of a registry-based cohort analysis.
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DOI：
10.1097/md.0000000000004531
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发表时间：
2016-12
期刊：
影响因子：
1.6
通讯作者：
Xu RH
中科院分区：
文献类型：
--
作者：
Bai L;Wang F;Li ZZ;Ren C;Zhang DS;Zhao Q;Lu YX;Wang DS;Ju HQ;Qiu MZ;Wang ZQ;Wang FH;Xu RH
补充数字内容可在文本中获取本观察性队列研究旨在阐明贝伐珠单抗或西妥昔单抗联合化疗作为中国转移性结直肠癌 (mCRC) 患者的一线治疗的疗效和安全性。临床数据来自一项单中心注册研究，其中 mCRC 患者在 2009 年 1 月至 2013 年 12 月期间接受一线氟嘧啶化疗联合贝伐单抗（188 例 KRAS 野生型或突变肿瘤患者）或西妥昔单抗（101 例 KRAS 野生型肿瘤患者）。采用 Kaplan-Meier 法进行生存分析。 Cox比例风险模型用于估计临床病理特征的预后和预测值。贝伐单抗组和西妥昔单抗组在中位无进展生存期（PFS）（10.6 个月 vs 8.7 个月，P = 0.317）、中位总生存期（OS）（27.7 个月 vs 28.3 个月，P = 0.525）或总有效率（43.1% vs 53.5%， P = 0.108）。对于腹膜播散的患者亚组，根据 PFS（9.6 个月与 6.1 个月）和 OS（26.3 与 12.7 个月）衡量，基于贝伐单抗的三联疗法似乎优于基于西妥昔单抗的三联疗法，但对于无腹膜播散的患者则不然（PFS，10.6 个月与 9.1 个月；OS，27.9 个月与 30.7 个月）（所有未经调整和调整的相互作用） P < 0.05）。我们的研究表明，基于贝伐珠单抗或西妥昔单抗的治疗方案与中国人群中转移性结直肠癌的一线治疗具有相似的疗效。腹膜播散患者可能从贝伐珠单抗中获得比西妥昔单抗治疗更多的益处。需要未来的前瞻性研究来进一步证实这些结果。
Supplemental Digital Content is available in the text The present observational cohort study was designed to elucidate the efficacy and safety profile of bevacizumab or cetuximab with chemotherapy as the first-line treatment in Chinese patients with metastatic colorectal cancer (mCRC). Clinical data were collected from a single-center registry study where mCRC patients received first-line fluoropyrimidine-based chemotherapy combined with either bevacizumab (188 patients with KRAS wild-type or mutated tumors) or cetuximab (101 patients with KRAS wild-type tumors) between January 2009 and December 2013. The Kaplan–Meier method was used for survival analysis. Cox proportional hazards model was used for estimating the prognostic and predictive values of clinicopathological characteristics. No statistically significant difference was observed between the bevacizumab and cetuximab groups in terms of median progression-free survival (PFS) (10.6 vs 8.7 months, P = 0.317), median overall survival (OS) (27.7 vs 28.3 months, P = 0.525), or overall response rate (43.1% vs 53.5%, P = 0.108). For the subset of patients with peritoneal dissemination, bevacizumab-based triplet appears to be superior to cetuximab-based triplet as measured by PFS (9.6 vs 6.1 months) and OS (26.3 vs 12.7 months), but not for patients without peritoneal dissemination (PFS, 10.6 vs 9.1 months; OS, 27.9 vs 30.7 months) (all unadjusted and adjusted interaction P < 0.05). Our study suggests that bevacizumab- or cetuximab-based regimens have similar effectiveness as first-line treatment of mCRC in Chinese population. Patients with peritoneal dissemination were likely to gain more benefit from bevacizumab than cetuximab treatment. Future prospective studies are required to further confirm these results.