The Role of Anti-EGFR Monoclonal Antibody in mCRC Maintenance Therapy.
The Role of Anti-EGFR Monoclonal Antibody in mCRC Maintenance Therapy.
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DOI：
10.3389/fmolb.2022.870395
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发表时间：
2022
影响因子：
5
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中科院分区：
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背景资料：表皮生长因子受体（EGFR）单克隆抗体（mAb）联合化疗治疗RAS（大鼠肉瘤病毒癌基因同源物）野生型转移性结直肠癌（mCRC）可以缓解和稳定病情，有效延长无进展生存期（PFS）和总生存期（OS），提高总缓解率（ORR），是目前RAS野生型mCRC的一线治疗标准方案。然而，抗EGFR mAb能否用于一线治疗mCRC后的维持治疗仍存在争议。本文就近年来抗EGFR单克隆抗体的研究进展作一综述。内容包括绪论、抗EGFR mAb在mCRC中的应用及其在一线治疗中的地位、mCRC标准一线治疗后维持治疗模式的建立、抗EGFR mAb在mCRC维持治疗中的研究进展和结论五个部分。越来越多的研究支持抗EGFR单克隆抗体的维持治疗，但也有研究者提出抗EGFR单克隆抗体存在费用高、耐药等问题。尽管抗EGFR mAb的维持治疗证据不足，特别是缺乏大规模III期前瞻性临床试验，但随着新证据的出现和治疗优势人群筛选的更加准确，一线化疗联合抗EGFR mAb治疗后，采用抗EGFR mAb单药或抗EGFR mAb联合氟尿嘧啶方案维持治疗可能会争取更多的治疗机会，优化治疗策略，延长治疗连续性，最终为合适的患者带来更多的生存益处。
Background: Epidermal growth factor receptor (EGFR) monoclonal antibodies (mAbs) combined with chemotherapy in patients with RAS (rat sarcoma viral oncogene homolog) wild-type metastatic colorectal cancer (mCRC) can alleviate and stabilize the disease, effectively prolong the progression-free survival (PFS) and overall survival (OS), and improve the overall response rate (ORR), which is the first-line treatment standard scheme for RAS wild-type mCRC currently. However, whether anti-EGFR mAb can be used for the maintenance treatment after the first-line treatment of mCRC remains controversial. We reviewed the recent studies on anti-EGFR mAb. The contents include five parts, introduction, anti-EGFR mAb in mCRC and its status in first-line therapy, establishment of the maintenance treatment pattern after the standard first-line treatment for mCRC, research progress of anti-EGFR mAb in mCRC maintenance therapy, and conclusion. More studies support the maintenance treatment of anti-EGFR mAb, but some researchers raise the problems about high cost and drug resistance. Despite lack of the maintenance evidence of anti-EGFR mAb, especially lack of large-scale phase III prospective clinical trials, with the emergence of new evidence and more accurate screening of treatment-dominant groups, maintenance therapy with anti-EGFR mAb monotherapy or anti-EGFR mAb combined with fluorouracil-based schemes after first-line chemotherapy combined with anti-EGFR mAb therapy might strive for more treatment opportunities, optimize treatment strategies and prolong treatment continuity, and finally, lead to more survival benefit for suitable patients.