通过优化患者选择,改善转移性结直肠癌的生存率
Tanios S Bekaii-Saab1, Afsaneh Barzi2,3, Mike Cusnir4
1Division of Hematology and Medical Oncology, Mayo Clinic in Arizona, Phoenix, Arizona.
Clinical advances in hematology & oncology : H&O
|May 28, 2024
概括
新的转移性结直肠癌治疗方法,包括果丁尼布,为耐火患者提供了选择. 现实世界的数据表明,在三里丁/提皮拉之前对regorafenib进行测序可能会改善生存率,并允许化疗休息.
科学领域:
- 在瘤学瘤学.
- 医学瘤学 医学瘤学
- 胃肠道瘤学 胃肠道瘤学
背景情况:
- 转移性结直肠癌 (mCRC) 的全身治疗选择随着最近的FDA批准而扩大.
- 目前对耐火性mCRC的选择包括使用或不使用贝瓦西祖马布的triflururidine/tipiracil和regorafenib.
- 临床试验证实了这些药物的安全性和有效性,延长了整体生存期.
研究的目的:
- 审查耐火性转移性结直肠癌的扩大治疗环境.
- 根据最近的临床和现实世界的数据,讨论第三线疗法的测序.
- 突出优化治疗持续时间和患者结果的考虑因素.
主要方法:
- 对fruquintinib,trifluridine/tipiracil和regorafenib的临床试验数据的审查.
- 对实践研究的分析,研究耐火mCRC中的治疗序列.
- 考虑对Regorafenib剂量升级的ReDOS研究结果.
主要成果:
- 果丁尼布是一种新的FDA批准的选择,用于耐火性mCRC.
- 现实世界的数据表明,在从雷戈拉费尼布转换为三里丁/蒂皮拉西尔时,潜在的生存益处和无化疗间隔.
- 对于优化治疗持续时间和最大限度地减少副作用而言,Regorafenib剂量升级至关重要.
结论:
- 在耐火mCRC中对第三线疗法的测序需要进一步的研究.
- 首先使用regorafenib,然后使用trifluridine/tipiracil的策略可能会带来优势.
- 治疗顺序的决定应该整合瘤特征,患者因素和先前的治疗反应.
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