J Clin Oncol:3期| 二线化疗联合钇90放射栓塞可显著延长结直肠癌肝转移患者的无进展生存期!

2021-09-21 Nebula MedSci原创

在结直肠癌肝转移患者的二线系统治疗中加用 TARE 可明显延长 PFS 和 hPFS

中国每年约有 40万 新确诊的肝癌患者,约占全球新增病例的 55%。约 60% 的结直肠癌 (CRC) 患者在确诊时已发生肝转移。大部分肝转移的结直肠癌患者死于肝转移灶进展。

钇90(Yttrium-90)具有能量高、半衰期短、发射纯β射线、组织穿透距离短等物理特性。钇90 微球治疗是一种选择性局部内放射疗法,已被证实是肝癌晚期的一种特效药,现已在美国、欧洲等地区上市多年,在50多个国家累计治疗超过10万人次,可显著延长患者的生存期,明显改善其生存质量。

本研究旨在评估经动脉钇90放射栓塞 (TARE) 联合二线系统化疗对结直肠癌肝转移 (CLM) 的影响

这是一项国际性、多中心、开放标签的 3 期试验,纳入了经以奥沙利铂或伊立替康为基础的一线治疗后进展的 CLM 患者,以1:1随机分成两组,接受二线化疗联合或不联合 TARE。主要终点是无进展生存期(PFS)和肝 PFS(hPFS)。

来自北美、欧洲和亚洲 95 个医疗中心的 428 名患者随机接受化疗(n=213)或化疗+TARE(n=215)。

两组的无进展生存期

在截止日期时,TARE 组和化疗组分别观察到了 140 例和 127 例 PFS 事件,中位 PFS 分别是 8.0 个月和 7.2 个月(风险比[HR] 0.69, 95% CI 0.54-0.88; p=0.0013)。TARE 组和化疗组的中位 hPFS 分别是 9.1 个月和 7.2 个月(HR 0.59, 95% CI 0.46-0.77; p<0.0001)。

两组的肝 PFS

TARE 组和化疗组的客观缓解率分别是 34.0%和 21.1%(p=0.0019)。TARE 组和化疗组的总生存期分别是 14.0 个月和14.4 个月(HR 1.07, 95% CI 0.86-1.32)。TRAE 组 3 级不良事件的发生率更高(68.4% vs 49.3%)。

综上,在结直肠癌肝转移患者的二线系统治疗中加用 TARE 可明显延长 PFS 和 hPFS

原始出处:

Mary F. Mulcahy, et al. Radioembolization With Chemotherapy for Colorectal Liver Metastases: A Randomized, Open-Label, International, Multicenter, Phase III Trial. Journal of Clinical Oncology. September 20, 2021. https://ascopubs.org/doi/full/10.1200/JCO.21.01839

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    2021-10-03 minlingfeng
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    2021-10-22 jiazhoudexue

    这真是一个神奇的**

    0

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    2021-09-21 ms5000000518166734

    已读已读已读已读已读已读已读已读已读已读已读已读已读已读已读已读已读已读已读

    0

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