FOLFIRI方案联合或不联合贝伐珠单抗治疗转移性GEP-NEC的疗效和安全性  

Efficacy and safety of FOLFIRI regimen with or without bevacizumab in the treatment of metastatic GEP-NEC

作　　者：赵晓莹[1,2] 张文[1,2] 尹海庆[3] 胡健[4] 王辰辰[1,2] 朱晓东[1,2] 郭伟剑[1,2] 陈治宇[1,2] 

机构地区：[1]复旦大学附属肿瘤医院肿瘤内科,上海200032 [2]复旦大学上海医学院肿瘤学系,上海200032 [3]河南宏力医院肿瘤内科,河南长垣453400 [4]解放军第455医院消化内科,上海200052

出　　处：《实用肿瘤杂志》2016年第5期462-468,共7页Journal of Practical Oncology

摘　　要：目的探讨FOLFIRI方案联合或不联合贝伐珠单抗治疗转移性胃肠胰神经内分泌癌（gastroenteropancreatic neuroendocrine carcinoma,GEP-NEC）的疗效和安全性。方法回顾性分析12例转移性GEP-NEC患者临床资料,采用FOLFIRI方案（伊立替康＋亚叶酸钙＋5-氟尿嘧啶）联合或不联合贝伐珠单抗治疗,收集疗效和不良反应相关数据。结果 12例患者中,6例（50.0%）为既往EP方案（依托泊苷＋顺铂）治疗失败,2例（16.7%）为其他方案（1例吉西他滨＋白蛋白紫杉醇,1例奥沙利铂＋卡培他滨）治疗失败,另4例为一线治疗。12例疾病控制率为83.3%（10/12）,其中7例（58.3%）为部分缓解（partial response,PR）,3例（25.0%）为疾病稳定（stable disease,SD）,2例（16.7%）为疾病进展（progressive disease,PD）。7例（58.3%）联合贝伐珠单抗治疗,其中4例（57.1%）PR,2例（28.6%）SD,1例（14.3%）PD。5例不联合贝伐珠单抗患者,其中3例（60.0%）PR,1例（20.0%）SD,1例（20.0%）PD。所有患者无进展生存时间为5.1月（3.8-6.4月）。Ⅲ-Ⅳ度毒性反应发生率为25.0%（3/12）,且均为Ⅲ度粒细胞减少,其他的常见不良反应包括贫血、转氨酶升高、高血压和蛋白尿等,均为Ⅰ-Ⅱ度。结论FOLFIRI方案联合或不联合贝伐珠单抗在转移性GEP-NEC患者中的缓解率良好且耐受性佳。Objective To investigate the efficacy and safety of FOLFIRI regimen with or without bevacizumab in treating metastatic gastroenteropancreatic neuroendocrine carcinoma（ GEP-NEC）. Methods The clinical data of 12 cases of metastatic GEP-NEC were retrospectively analyzed. All patients received FOLFIRI regimen（ irinotecan,CF with 5-FU）with or without bevacizumab treatment. Clinical data related to treatment efficacy and toxicity were collected. Results In the 12 cases,6 cases（ 50. 0%） received EP regimen（ etoposide with cisplatin） as their first line therapy but failed to response,2 cases（ 16. 7%） failed first line therapies of other regimens（ 1 case of gemcitabine with nab-paclitaxel,another with oxaliplatin and capecitabine）,and the remained 4 cases were untreated. The disease control rate was 83. 3%（ 10 /12）,with 7 cases（ 58. 3%） of partial response（ PR）,3 cases（ 25. 0%） of stable disease（ SD）,and 2 cases（ 16. 7%） of progressive disease（ PD）. Among the 7 patients who received combined therapy with bevacizumab,4 cases（ 57. 1%） were PR,2 cases（ 28. 6%） were SD and 1 case（ 14. 3%） was PD. Among those without bevacizumab（ n = 5）,3 cases（ 60. 0%） were PR,1 case（ 20. 0%） was SD,1 case（ 20. 0%） was PD. The median progression free survival time was5. 1 months（ 3. 8- 6. 4 months）. Besides,the occurrence rate of Ⅲ-Ⅳ grade toxicities was 25. 0%（ 3 /12）,and all presented as Ⅲ grade neutropenia. Other common adverse effects were all Ⅰ-Ⅱ grade reactions,including anemia,transient transferase elevation and proteinuria. Conclusion FOLFIRI regimen with or without bevacizumab showed promising treatment response and high tolerance in treating metastatic GEP-NEC.

关 键 词：胃肠肿瘤/药物疗法 胰腺肿瘤/药物疗法 癌 神经内分泌/药物疗法 抗肿瘤联合化疗方案/治疗应用 顺铂/治疗应用 依托泊甙/治疗应用 抗体 单克隆/治疗应用 血管生成抑制剂/治疗应用 治疗结果 安全 回顾性研究 

分 类 号：R735[医药卫生—肿瘤] R730.53[医药卫生—临床医学]