ASCO 2021: 摘要概览与展望 9:结直肠癌一线治疗方案

2021-05-26 K.K MedSci原创

结直肠癌(Colorectal cancer,CRC)是最常见的恶性肿瘤之一,其发病率及死亡率均高居我国恶性肿瘤的前五位。分子水平的检测可为结直肠癌的诊断及个体化治疗的实施提供依据。大量的随机证据支持

结直肠癌(Colorectal cancer,CRC)是最常见的恶性肿瘤之一,其发病率及死亡率均高居我国恶性肿瘤的前五位。分子水平的检测可为结直肠癌的诊断及个体化治疗的实施提供依据。大量的随机证据支持在转移性结直肠癌中使用中断治疗,尽管毒性降低,但并没有普遍向患者提供中断治疗,也没有对总生存期造成损害。先前的试验表明,卡培他滨和贝伐单抗的联合治疗可以延长PFS(无进展生存期),但不能延长总生存期。FOCUS4-N探讨了在一线治疗中疾病得到控制的患者中口服维持性卡培他滨单药治疗。

FOCUS4是一项分子分层试验计划,对来自英国88家医院的新诊断的转移性结直肠癌患者进行登记。在接受16周的一线治疗期间,肿瘤样本被送去进行实验室测试,以将他们的疾病分为分子亚型:MSI、BRAF、PIK3CA、TP53和RAS基因突变。对于某些分子组,可以进行靶向治疗分试验,但对于无法进行靶向分试验的患者,可以进入FOCUS4-N试验。患者按1:1的比例随机选择维持卡培他滨治疗或AM治疗。主要结果是使用8周一次的RECIST的CT扫描评估出的PFS,生活质量(使用EQ5D健康指数量表 8周)和OS作为次要结果,毒性和耐受性每4周评估一次。在病情进展时,从最低点开始,患者重新开始一线治疗。通过调整肿瘤位置、转移负担、一线治疗和生物标志物亚型,用Cox回归法评估意向治疗(ITT)的疗效。

在2014年3月~2020年3月期间,254名患者被随机分配(127名卡培他滨组和127名AM组)。AM组的事件发生率高于预期,患者的治疗的依从性很好。卡培他滨组 vs AM的毒性是预期之中的,腹泻(23%vs13%)和手足综合症(26%vs3%)等。生活质量在两组之间没有统计学上的显著差异。

尽管强有力的证据表明维持治疗会延长PFS,但OS仍然不受影响,在治疗间歇期对转移性结直肠癌一线治疗稳定或反应良好的患者的安全疗法,FOCUS4-N的研究提供了更多的证据。在联合治疗16周后,未使用贝伐珠单抗的卡培他滨组可延长PFS。临床试验信息。ISRCTN#90061546。

原文出处:

https://meetinglibrary.asco.org/record/195966/abstract

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1939173, encodeId=802019391e3e7, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sat Oct 30 17:22:51 CST 2021, time=2021-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1905165, encodeId=9e641905165e7, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Sun Dec 05 10:22:51 CST 2021, time=2021-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=969212, encodeId=78529692127a, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=327b5320850, createdName=148aa5c4m83(暂无昵称), createdTime=Fri May 28 13:56:54 CST 2021, time=2021-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453516, encodeId=fa351453516de, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Fri May 28 08:22:51 CST 2021, time=2021-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=968722, encodeId=1b9d968e22ad, content=<a href='/topic/show?id=dbe71042839b' target=_blank style='color:#2F92EE;'>#ASCO2021#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104283, encryptionId=dbe71042839b, topicName=ASCO2021)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20221103/2796e00c9b4549e3b313ed9e7accc68f/b52d6d98bbe04782b5a4e2dd1ee80be2.jpeg, createdBy=078e1614372, createdName=MedSciZeng, createdTime=Wed May 26 20:06:39 CST 2021, time=2021-05-26, status=1, ipAttribution=)]
    2021-10-30 quxin068
  2. [GetPortalCommentsPageByObjectIdResponse(id=1939173, encodeId=802019391e3e7, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sat Oct 30 17:22:51 CST 2021, time=2021-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1905165, encodeId=9e641905165e7, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Sun Dec 05 10:22:51 CST 2021, time=2021-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=969212, encodeId=78529692127a, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=327b5320850, createdName=148aa5c4m83(暂无昵称), createdTime=Fri May 28 13:56:54 CST 2021, time=2021-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453516, encodeId=fa351453516de, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Fri May 28 08:22:51 CST 2021, time=2021-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=968722, encodeId=1b9d968e22ad, content=<a href='/topic/show?id=dbe71042839b' target=_blank style='color:#2F92EE;'>#ASCO2021#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104283, encryptionId=dbe71042839b, topicName=ASCO2021)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20221103/2796e00c9b4549e3b313ed9e7accc68f/b52d6d98bbe04782b5a4e2dd1ee80be2.jpeg, createdBy=078e1614372, createdName=MedSciZeng, createdTime=Wed May 26 20:06:39 CST 2021, time=2021-05-26, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1939173, encodeId=802019391e3e7, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sat Oct 30 17:22:51 CST 2021, time=2021-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1905165, encodeId=9e641905165e7, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Sun Dec 05 10:22:51 CST 2021, time=2021-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=969212, encodeId=78529692127a, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=327b5320850, createdName=148aa5c4m83(暂无昵称), createdTime=Fri May 28 13:56:54 CST 2021, time=2021-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453516, encodeId=fa351453516de, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Fri May 28 08:22:51 CST 2021, time=2021-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=968722, encodeId=1b9d968e22ad, content=<a href='/topic/show?id=dbe71042839b' target=_blank style='color:#2F92EE;'>#ASCO2021#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104283, encryptionId=dbe71042839b, topicName=ASCO2021)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20221103/2796e00c9b4549e3b313ed9e7accc68f/b52d6d98bbe04782b5a4e2dd1ee80be2.jpeg, createdBy=078e1614372, createdName=MedSciZeng, createdTime=Wed May 26 20:06:39 CST 2021, time=2021-05-26, status=1, ipAttribution=)]
    2021-05-28 148aa5c4m83(暂无昵称)

    学习了,谢谢分享

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1939173, encodeId=802019391e3e7, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sat Oct 30 17:22:51 CST 2021, time=2021-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1905165, encodeId=9e641905165e7, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Sun Dec 05 10:22:51 CST 2021, time=2021-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=969212, encodeId=78529692127a, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=327b5320850, createdName=148aa5c4m83(暂无昵称), createdTime=Fri May 28 13:56:54 CST 2021, time=2021-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453516, encodeId=fa351453516de, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Fri May 28 08:22:51 CST 2021, time=2021-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=968722, encodeId=1b9d968e22ad, content=<a href='/topic/show?id=dbe71042839b' target=_blank style='color:#2F92EE;'>#ASCO2021#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104283, encryptionId=dbe71042839b, topicName=ASCO2021)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20221103/2796e00c9b4549e3b313ed9e7accc68f/b52d6d98bbe04782b5a4e2dd1ee80be2.jpeg, createdBy=078e1614372, createdName=MedSciZeng, createdTime=Wed May 26 20:06:39 CST 2021, time=2021-05-26, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1939173, encodeId=802019391e3e7, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sat Oct 30 17:22:51 CST 2021, time=2021-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1905165, encodeId=9e641905165e7, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Sun Dec 05 10:22:51 CST 2021, time=2021-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=969212, encodeId=78529692127a, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=327b5320850, createdName=148aa5c4m83(暂无昵称), createdTime=Fri May 28 13:56:54 CST 2021, time=2021-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453516, encodeId=fa351453516de, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Fri May 28 08:22:51 CST 2021, time=2021-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=968722, encodeId=1b9d968e22ad, content=<a href='/topic/show?id=dbe71042839b' target=_blank style='color:#2F92EE;'>#ASCO2021#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104283, encryptionId=dbe71042839b, topicName=ASCO2021)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20221103/2796e00c9b4549e3b313ed9e7accc68f/b52d6d98bbe04782b5a4e2dd1ee80be2.jpeg, createdBy=078e1614372, createdName=MedSciZeng, createdTime=Wed May 26 20:06:39 CST 2021, time=2021-05-26, status=1, ipAttribution=)]

相关资讯

梅斯肿瘤进展速递(第005期)

编者按:梅斯医学将定期进行汇总,帮助大家概览肿瘤领域最新进展。下面是呈现给大家的最近一期的肿瘤进展。enjoy~

默克在ASCO21上呈报的肿瘤产品阵容数据突显癌症治疗的重大进展

关键性研究的新分析强调BAVENCIO®在晚期尿路上皮癌不同亚组治疗中的独特临床获益

Nat Ecol Evol:颠覆性发现:肿瘤中心的癌细胞易扩散全身,它们遭受最恶劣的环境,也因此更强大

2021年5月17日,弗朗西斯·克里克研究所/伦敦大学学院的研究人员在 Nature 子刊 Nature Ecology & Evolution 期刊发表了题为:Selection of metast

Dig Dis Sci: 早发性大肠癌患者发生第二原发恶性肿瘤的风险增加

结直肠癌(CRC)是美国人群中第三大最常见的癌症。在美国,CRC的总体发病率正在下降,这在很大程度上归功于诸如结肠镜检查之类的筛查方法的使用增加。

DIA 2021:抗肿瘤联合用药开发策略考量

如何从临床亟需角度出发,提高现有抗肿瘤治疗的临床获益是当下新药开发的热点。CDE 基于国内临床开发的现状,于2020年12月30日正式发布了