贝伐珠单抗联合双周方案一线治疗晚期大肠癌的疗效及与K-ras基因的关系  

The efficacy of bevacizumab plus bi- weekly chemotherapy for patients with advanced colorectal cancer as first- line treatment and the relationship with K- ras gene

作　　者：夏学明 毛志远[1] 白莉[1] 

机构地区：[1]解放军总医院肿瘤内一科,北京100853

出　　处：《现代肿瘤医学》2015年第8期1090-1093,共4页Journal of Modern Oncology

摘　　要：目的:探讨贝伐珠单抗(BEV)联合双周方案一线治疗晚期大肠癌的临床疗效及与K-ras基因的关系。方法:收集2008年1月至2014年2月解放军总医院收治、经病理确诊的46例K-ras基因状态明确的晚期大肠癌患者临床资料,其中K-ras野生型23例、K-ras突变型23例;回顾性分析了BEV联合FOLFIRI(20例)或FOLFOX(26例)方案在一线治疗晚期大肠癌中的疗效及毒副反应的情况,并分析K-ras基因突变与疗效的关系。结果:46例均可评价近期疗效,总ORR为39.1%,总DCR为91.3%,总中位PFS为7.5个月。以化疗方案分组,其中FOLFIRI+BEV组ORR为30.0%,DCR为95.0%,中位PFS为8.1个月;FOLFOX+BEV组ORR为46.2%,DCR为88.5%,中位PFS为6.5个月。以K-ras基因状态分组,K-ras突变组ORR为30.4%,DCR为91.3%,中位PFS为6.2个月;K-ras野生组ORR为47.8%,DCR为91.3%,中位PFS为9.9个月。以上差异均无统计学意义(P>0.05)。结论:虽然K-ras突变组在近期、远期疗效低于K-ras野生组,但在两组中均可见应用BEV能获益,同时再次证实K-ras基因突变是患者预后不良因素之一,但不是BEV应用的禁忌症;在化疗方案方面,BEV联合FOLFIRI或FOLFOX标准双周方案可提高化疗的ORR及DCR,且毒副反应小,安全性较好。Objective：To explore the efficacy of bevacizumab plus bi -weekly chemotherapy for patients with ad- vanced colorectal cancer as first - line treatment and the relationship with K - ras gene. Methods： From January 2008 to February 2014,46 patients diagnosed as advanced colorectal cancer with pathology and K - ras gene status con- firmed in the People＇s Liberation Army General Hospital were collected, of which 23 cases were K - ras wild - type and 23 cases were K -ras mutation. The efficacy and safety of bevacizumab plus FOLFIRI （20 cases） or FOLFOX （26 cases） regimen as first- line chemotherapy were analyzed retrospectively and also analyzed the relationship be- tween K - ras gene mutation and efficacy. Results：All 46 patients were evaluable. The overall response rate was 39.1% ,the overall disease control rate was 91.3% ,the overall median PFS was 7.5 months. Grouping with chemo- therapy,the response rates of FOLFIRI ＋ BEV group was 30.0%, the disease control rate of FOLFIRI ＋ BEV group was 95.0%, the median PFS of FOLFIRI ＋ BEV group was 8.1 months, the response rate of FOLFOX ＋ BEV group was 46.2% ,the disease control rates of FOLFOX ＋ BEV group was 88.5% ,the median PFS of FOLFOX ＋ BEV group was 6.5 months. Grouping with K - ras gene status, the response rates of K - ras mutation group was 30.4%, the disease control rate of K - ras mutation group was 91.3%, the median PFS of K - ras mutation group was 6.2 months. The response rates of K - ras wild - type group was 47.8% ,the disease control rates of K - ras wild - type group was 91.3% ,the median PFS of K - ras wild - type group was 9.9 months. These differences were not statisti- cally significant（ P 〉0.05 ）. Conclusion： Although the short- term and long- term efficacy of the K- ras mutation group were less than K - ras wild - type group, but both groups can get benefit from bevacizumab. And our study also confirmed again that K - ras gene mutation was one of poor prognostic factors, but was not the contraindication of ap-

关 键 词：晚期大肠癌 化学治疗 K-RAS基因 贝伐珠单抗 

分 类 号：R735.34[医药卫生—肿瘤]