Impact of Primary Tumor Location on First-line Bevacizumab or Cetuximab in Metastatic Colorectal Cancer

医学 贝伐单抗 西妥昔单抗 伊立替康 肿瘤科 结直肠癌 临床终点 内科学 原发性肿瘤 奥沙利铂 癌症 不利影响 疾病 化疗 临床试验 转移
作者
Matthew Snyder,Sal Bottiglieri,Khaldoun Almhanna
出处
期刊:Reviews on Recent Clinical Trials [Bentham Science Publishers]
卷期号:13 (2): 139-149 被引量:24
标识
DOI:10.2174/1574887113666180328104109
摘要

Background: Colorectal cancer is one of the most common malignancies in the United States, with a large proportion of patients presenting with metastatic disease or developing a recurrence. Systemic chemotherapy is the mainstay of therapy in this setting. There is a clear benefit in the addition of bevacizumab or cetuximab (for rat sarcoma [RAS] wild type tumors) to oxaliplatin- and irinotecan-based regimens which can be considered for first-line therapy. However, many significant questions remain as to which agent reflects best practice. Objective: Our review aimed to elucidate the benefit of adding bevacizumab and cetuximab to initial therapy for metastatic colorectal cancer based on primary tumor location and a variety of other disease- and patient-related factors, addressing the paucity of evidence that currently exists in this area and contributing to current literature and clinical practices. Methods: The primary endpoints of the study were first Progression-Free Survival (PFS) and Overall Survival (OS). Secondary endpoints included best response to first- and second-line therapies, Treatment- Related Adverse Events (TRAEs), second PFS, cost of therapy, and an assessment of other patient- and disease-related factors affecting PFS and OS. Results: While there were trends towards improved OS in patients with left-sided primary tumors (n=57) compared to those with right-sided disease (n=23), there were no significant differences between the two groups in either primary endpoint. While no differences were found for patients with left- or right- sided tumors stratified by add-on agent, these analyses were limited by the small number of patients receiving cetuximab with first-line therapy (n=4). However, the bevacizumab cohort (n=76) was sizable enough to provide ample data and produce clinically relevant results. Add-on therapy with bevacizumab in our study achieved impressive survival outcomes in both left-sided (median first PFS = 13 months, 95% CI 11-15 months; median OS = 37 months, 95% CI 21-53 months) and right-sided (median first PFS = 13 months, 95% CI 9-17 months; median OS = 37 months, 95% CI 22-52 months) disease. Conclusion: These results raised questions regarding the true significance of primary tumor location when selecting bevacizumab or cetuximab for first-line therapy, particularly the current thought of using cetuximab for left-sided tumors. While the superiority of bevacizumab over cetuximab in rightsided disease remained evident upon comparison of our analysis with historical controls, survival outcomes with the agent in our analysis appeared to be similar to that of cetuximab in CRYSTAL, FIRE- 3, and CALGB/SWOG 80405 in left-sided disease. Further study is required to determine if bevacizumab truly does produce similar outcomes to cetuximab in left-sided primary tumors. Keywords: Bevacizumab, cetuximab, left-sided tumors, metastatic colorectal cancer, primary tumor location, right-sided tumors, targeted therapy.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
Cici发布了新的文献求助10
刚刚
二十又澪发布了新的文献求助10
刚刚
1秒前
望北楼主发布了新的文献求助10
1秒前
酷波er应助Calvin采纳,获得10
2秒前
苏晓聪完成签到,获得积分10
2秒前
3秒前
奔放的老青年完成签到,获得积分10
3秒前
何止完成签到,获得积分10
4秒前
大模型应助迅速的代桃采纳,获得10
4秒前
5秒前
科研通AI2S应助1234采纳,获得10
6秒前
李二牛完成签到,获得积分10
6秒前
在水一方应助Miki采纳,获得10
6秒前
典雅碧空发布了新的文献求助10
6秒前
kimiweiwei发布了新的文献求助10
7秒前
Jc完成签到 ,获得积分10
7秒前
7秒前
今后应助王才强采纳,获得10
8秒前
zjq完成签到,获得积分10
8秒前
暮光微凉完成签到,获得积分10
9秒前
9秒前
12秒前
无花果应助Zymiao采纳,获得10
12秒前
13秒前
小王爱学习给小王爱学习的求助进行了留言
14秒前
Liu关闭了Liu文献求助
15秒前
16秒前
Ni发布了新的文献求助10
16秒前
16秒前
kimiweiwei完成签到,获得积分10
18秒前
1234发布了新的文献求助10
18秒前
wangying完成签到,获得积分10
19秒前
狗子完成签到 ,获得积分10
20秒前
身强力壮运气好完成签到,获得积分10
20秒前
Miki发布了新的文献求助10
20秒前
Cici发布了新的文献求助10
21秒前
抽屉里的砖头完成签到,获得积分10
21秒前
黑虎发布了新的文献求助10
22秒前
24秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Cognitive Neuroscience: The Biology of the Mind 1000
Technical Brochure TB 814: LPIT applications in HV gas insulated switchgear 1000
Toward a Combinatorial Approach for the Prediction of IgG Half-Life and Clearance 500
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Picture Books with Same-sex Parented Families: Unintentional Censorship 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3969940
求助须知:如何正确求助?哪些是违规求助? 3514642
关于积分的说明 11175298
捐赠科研通 3249947
什么是DOI,文献DOI怎么找? 1795178
邀请新用户注册赠送积分活动 875617
科研通“疑难数据库(出版商)”最低求助积分说明 804891