甲磺酸阿帕替尼在多线治疗失败的晚期结肠癌中的近期临床疗效与安全性观察  

Observation of apatinib mesylate treatment on colon cancer failed in multi-line chemotherapy

作　　者：王珊珊 汪海岩 武斌 赵利红 李栋[3] 谢彦 WANG Shanshan;WANG Haiyan;WU Bin;ZHAO Lihong;LI Dong;XIE Yan(Department of Oncology,Hospital Affiliated to Xuzhou Medical University,Xuzhou 221003,China)

机构地区：[1]徐州医科大学研究生学院,221004 [2]徐州医科大学附属医院肿瘤内科,江苏徐州221003 [3]徐州市中心医院肿瘤内科,221008 [4]徐州矿务集团总医院肿瘤内科,221006

出　　处：《临床肿瘤学杂志》2018年第5期453-457,共5页Chinese Clinical Oncology

摘　　要：目的探讨甲磺酸阿帕替尼在多线治疗失败的晚期结肠癌治疗中的疗效及不良反应。方法收集2016年6月至2017年12月31例多线治疗失败的晚期结肠癌患者,接受甲磺酸阿帕替尼单药(n=7)或联合化疗(n=24)治疗。阿帕替尼初始剂量为425 mg/d,联合化疗药物包括替吉奥、伊立替康或奥沙利铂。采用RECIST 1.1版标准和NCI CTC 3.0版标准分别评价近期疗效和不良反应,并观察全组患者的无进展生存期(PFS)。结果治疗4周后31例可评价疗效的患者中,获部分缓解(PR)5例、稳定(SD)18例、进展(PD)8例,有效率(RR)为16.1%(5/31),疾病控制率(DCR)为74.2%(23/31)。治疗8周后30例可评价疗效的患者中,获PR 3例、SD 18例、PD 9例,RR为10.0%(3/30),DCR为70.0%(21/30)。接受阿帕替尼单药或联合化疗近期疗效的差异无统计学意义(P>0.05)。31例患者的中位PFS为3.5个月,不同性别、年龄、肿瘤原发部位、转移部位及是否联合化疗之间PFS的差异无统计学意义(P>0.05)。不良反应主要为高血压、蛋白尿、手足综合征、肝功能异常、血液系统毒性和乏力,以1~2级为主。高血压及蛋白尿发生率较高,均为16.1%。结论甲磺酸阿帕替尼治疗多线治疗失败的晚期结肠癌的近期疗效显著,毒性可控,可作为多线治疗失败的晚期结肠癌患者的一种有效的治疗选择,以期延长患者的生存期。Objective To investigate the efficacy and safety of apatinib mesylate on advanced colon cancer failed in multi-line treatment. Methods From June 2016 to December 2017,31 cases of advanced colon cancer failed in multi-line treatment received apatinib mesylate monotherapy（ n = 7） or in combination with chemotherapy（ n = 24） were enrolled in this study. The initial dose of apatinib was 425 mg/d. Chemotherapy drugs included S-1,oxaliplatin and irinotecan. Clinical efficacy and side effect were evaluated by RECIST1. 1 criteria and NCI CTC 3. 0 criteria,respectively. Progression-free survival（ PFS） was also observed. Results After 4 weeks of apatinib treatment,among the 31 patients could be evaluated,partial remission（ PR） was found in 5 cases,stable disease（ SD） in 18 cases,and progression disease（ PD） in 8 cases. The response rate was 16. 1%（5/31）,and disease control rate was 74. 2%（23/31）.After 8 weeks of apatinib treatment,among the 30 patients could be evaluated,PR was found in 3 cases,SD in 18 cases,and PD in 9 cases. The RR was 10. 0%（3/30）,and DCR was 70. 0%（21/30）. The short-term efficacy between those received apatinib monotherapy or in combination with chemotherapy had no differences（ P〉0. 05）. The median PFS of 31 patients was 3. 5 months. There was no significant difference in PFS between different sex,age,primary site of tumor,metastatic site of tumor and whether in combination with chemotherapy（ P〉0. 05）. The main adverse reactions were hypertension,proteinuria,hand-foot syndrome,abnormal liver function,hematological toxicity and fatigue,mainly in grade 1-2. The incidence of hypertension and proteinuria（ both 16. 1%） was higher than other adverse reactions. Conclusion Apatinib mesylate for patients of advanced colon cancer failed in multi-line treatment is effective,and the adverse reactions are tolerable,which can be regarded as a choice for advanced colon cancer failed in multi-line treatment.

关 键 词：结肠癌 甲磺酸阿帕替尼 临床疗效 安全性 

分 类 号：R735.35[医药卫生—肿瘤]