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1.
晚期结直肠癌靶向治疗药物主要包括血管内皮生长因子抑制剂和表皮生长因子受体抑制剂.研究表明贝伐珠单抗和西妥昔单抗改善了晚期结直肠癌的预后,但在联合化疗药物方案的选择上稍有差异.西妥昔单抗和贝伐珠单抗改善K-ras野生型晚期结直肠癌患者总生存期相似.新的靶向药物阿柏西普、瑞格非尼等的出现,为晚期结直肠癌的靶向治疗提供了更多的选择. 相似文献
2.
大肠癌是最常见的恶性肿瘤之一,近年来靶向治疗的成功应用为大肠癌患者带来了新的希望。针对血管内皮生长因子(VEGF)和表皮生长因子受体(EGFR)的单克隆抗体(贝伐单抗和西妥昔单抗)已在临床上广泛应用。本文就目前大肠癌靶向治疗方面的新进展进行综述。 相似文献
3.
A recent subgroup analysis of the TRIBE trial suggested that FOLFOXIRI plus bevacizumab may be a preferred option for the first-line treatment of only right-sided metastatic colorectal cancer (mCRC), regardless of RAS or BRAF status. Our subanalysis of a phase II trial of the FOLFOXIRI triplet regimen plus bevacizumab in patients with mCRC who had RAS mutant tumors showed that tumor shrinkage was better and the duration of treatment was longer in patients with left-sided tumors than in those with right-sided tumors, leading to a higher rate of conversion to surgery in mCRC patients with left-sided tumors. The early and deep responses to the triplet-regimen in patients with left-sided tumors might facilitate conversion treatment resulting in favorable survival. Our data suggest that the FOLFOXIRI plus bevacizumab might be a promising treatment for left-sided mCRC involving RAS mutant tumors. 相似文献
4.
阐述了贝伐单抗(BV)与西妥昔单抗(C225)治疗晚期或转移性大肠癌(CRC)的作用。分子靶向药物BV与C225能特异性阻断血管内皮生长因子(VEGF)和表皮生长因子受体(EGFR)的生物效应,临床应用治疗CRC有效且耐受良好,它与细胞毒药物不同,主要是抑制肿瘤生长,而不是缩小,与化疗联合应用可望增强疗效,延长生存期与改善生活质量。 相似文献
5.
BackgroundPrimary tumor location (PTL) is a major prognostic factor in metastatic colorectal cancer (mCRC) with left side which present better prognosis than right sided. Uncertainty exists regarding comparative effectiveness of irinotecan or oxaliplatin doublet in mCRC in function of PTL. MethodsWe conducted a retrospective comparing clinical outcomes from both regimens in function of sidedness. Patients with newly diagnosed mCRC candidates to first-line chemotherapy were selected. Clinical outcomes were assessed and stratified by tumor location (left, right and rectal) and type of treatment. ResultsOverall, 702 patients met the inclusion criteria. Primary colon cancer was right-sided in 248 (35.3%) patients, left-sided in 296 (42.2%) and rectal in 158 (22.5%) patients. Whatever PTL monochemotherapy give poor progression-free survival (PFS) and overall survival (OS). Triplet give better PFS and OS only for rectal cancer. When looking at doublet in first line. Folinic acid, 5FU, and irinotecan (FOLFIRI) give better PFS in rectal cancer [PFS of 21.2 (95% CI: 14.9–NR) versus 12.2 (95% CI: 10.1–13.4) months for the folinic acid, 5FU, and oxaliplatin (FOLFOX) group, P=0.009] and at trend for better PFS in right side tumor [14.9 (95% CI: 8.8–20.8) versus 11.3 (95% CI: 8.4–13.2) months for the FOLFOX group. P=0.0755]. No difference was observed in term of OS. Conclusionsour results support that either FOLFIRI or FOLFOX regimens give similar efficacy in both left and right metastatic colic cancer. FOLFIRI and FOLFIRINOX regimens might be preferred for metastatic rectal carcinoma. 相似文献
6.
晚期转移性结直肠癌的5年生存率低于10%。5-FU/LV方案治疗的中位生存期大约12个月。最近化疗方案的更新延长了患者的中位生存期。研究发现奥沙利铂、伊立替康联合5-FU/LV或者卡培他滨等化疗方案使中位生存期延长到20个月。奥沙利铂,伊立替康联合5-FU/LV比传统的单药5-FU/LV使生活质量改善时间延长。目前转移性结直肠癌标准的一线治疗方案为FOLFOX和FOLFIRI。正在进行的研究关注新的分子靶向药物(molecular targeted therapy)联合化疗治疗转移性结直肠癌,且部分试验取得了较好的疗效。本文将对5-FU、新一代化疗药物以及分子靶向药物在转移性结肠癌治疗的演进及新进展作一综述。 相似文献
7.
Background The past years’ therapy for colorectal cancer has evolved rapidly with the introduction of novel cytotoxic agents such as
irinotecan, capecitabine and oxaliplatin. Further advances have been achieved with the integration of targeted agents such
as bevacizumab, cetuximab and recently, panitumumab. As a result, third-line treatment is now a necessary step in the optimal
treatment of patients with metastatic colorectal cancer (MCRC).
Materials and methods We conducted a literature review of English language publications on third-line therapy for MCRC from January 2000 to April
2007. Data on median overall survival (mOS), median time to progression (mTTP) and response rate were recorded.
Results We found 27 articles and 22 abstracts to fulfil the criteria. Patients who received regimens containing oxaliplatin and infusional
5-fluorouracil (5-FU) demonstrated mTTP up to 7 months and a mOS of 16 months. With irinotecan and 5-FU, mOS around 8 months
were reported and with cetuximab combined with irinotecan, the highest mOS was 9.8 months.
Conclusion Third-line therapy in advanced colorectal cancer may improve mOS for patients with MCRC. Therefore, randomized studies should
be conducted in the future. 相似文献
8.
结直肠癌是全球发病率第三的恶性肿瘤.目前晚期结直肠癌的治疗以化疗为基石.2021年美国临床肿瘤学会(American Society of Clinical Oncology,ASCO)及欧洲肿瘤内科学(European Society of Medical Oncology,ESMO)公布了多项晚期结直肠癌免疫及靶向... 相似文献
9.
目的比较5-氟尿嘧啶(5-Fu)或卡培他滨联合奥沙利铂治疗转移性结直肠癌的临床疗效和安全性。方法以转移性结直肠癌、奥沙利铂、5-Fu、卡培他滨为检索词,查阅2011年6月前发表的有关5-Fu或卡培他滨联合奥沙利铂治疗转移性结直肠癌的随机对照研究。由2名作者各自独立对入选文献中试验设计、研究对象的特征、研究结果等内容按照预先制订的数据表进行摘录。采用RevMan4.2软件进行统计分析。结果按照筛选标准,共有6篇文献入选,全部研究共计2189例转移性结直肠癌患者。两组患者基本特征均衡可比。临床疗效方面,有效率合并相对危险度(RR)为0.92[95%CI(0.82,1.02),P=0.121,中位无疾病进展生存时间、中位生存时间合并加权均数差(WMD)分别为-0.19[95%CI(-0.73,0.35),P=0.49],-1.91[95%CI(-2.53,0.16),P:0.08],综合分析结果两组间均无优劣。Ⅲ~Ⅳ级毒副作用的比较中,中性粒细胞减少的综合分析显示卡培他滨组的发生率显著低于5-Fu组,合并RR为0.24[95%a(0.11,0.55),P=0.0007],而手足症状发生率高于5-Fu组,合并RR为2.83[95%a(1.66,4.82),19=0.0001]。结论5-Fu或卡培他滨联合奥沙利铂治疗转移性结直肠癌疗效无优劣。在Ⅲ~Ⅳ级毒性方面中性粒细胞减少在5-Fu组更易发生,卡培他滨组主要以手足症状为主。 相似文献
10.
抗血管生成治疗是转移性肾细胞癌的标准治疗。近年来,肿瘤新生血管通路的众多抑制剂纷纷进入临床研究,部分靶向药物取得良好的临床疗效。其他信号通路阻断剂如哺乳动物雷帕霉素靶蛋白与成纤维生长因子受体通路抑制剂也取得一定的成果。 相似文献
11.
In patients with metastatic colorectal cancer, the liver is the most common site of metastatic disease. In patients with liver-dominant disease, consideration needs to be given to locoregional treatments such as hepatic arterial infusion chemotherapy, transarterial chemoembolisation and selective internal radiation therapy because hepatic metastases are a major cause of liver failure especially in chemorefractory disease. In this review we provide insights on the published literature for locoregional treatment of liver metastases in metastatic colorectal cancer. 相似文献
12.
Introduction: Since late 1990’s therapy of metastatic colorectal cancer (mCRC) patients has changed considerable, and the combination of doublet or triplet chemotherapy and a targeted agent are now routinely used. With the introduction of more intensified regimens, it has become even more important to identify patients that will benefit from and can tolerate therapy. Furthermore, the increasing understanding of the biology of mCRC has led to the discovery of new potential targets. Therefore, therapy of patients with mCRC has undergone considerable change from ‘one strategy fits all’ towards a more personalized therapy. Areas covered: We present an overview of the recent literature on approved systemic treatment of mCRC however with focus on how the treatment strategy has changed based on clinical and molecular parameters that presently are used routinely in the clinical situation. Expert commentary: The face of treatment of mCRC has changed from ‘one strategy fits all’ to a personalized approach in which both clinical, molecular parameters and the aim of therapy have to be taking into account when planning the optimal treatment strategy for the individual mCRC patient. 相似文献
13.
A proliferation of new cytotoxic and biologic agents has led to improved survival in patients with metastatic colorectal cancer (mCRC). The ability of surgery to increase long-term survival in patients with liver and/or lung metastases also has been firmly established. It has become increasingly difficult as the numbers and types of treatment options have expanded to identify optimal drug combinations, sequences, and duration and the best way to integrate systemic chemotherapy with potentially curative surgery for metastatic lesions. For this review, the authors examined how recent clinical trials have addressed some pertinent questions regarding the use of systemic chemotherapy and biologic agents in patients with mCRC. 相似文献
14.
大肠癌为消化道常见恶性肿瘤之一,但传统的化疗效果仍不理想。新近在分子靶向治疗方面已经取得了实质性的进展,其高效低毒的特性越来越引起人们的重视。本文就目前在大肠癌分子靶向治疗方面的新进展进行综述。 相似文献
15.
食管癌是侵袭性较高的消化道恶性肿瘤。尽管外科技术及多学科综合治疗不断发展,食管癌的预后及整体生存仍较差。近年来,新型分子靶向治疗的发展如火如荼。靶向药物以肿瘤相关的信号通路为靶点,阻断下游信号的传导,起到抑制肿瘤细胞生长和转移的作用。目前正式批准的食管癌靶向药物较少,以HER-2 抑制剂为代表,主要用于HER-2 阳性表达的转移性腺癌。新型制剂的研究尚不广泛,不深入。本文就转移性食管癌新型靶向治疗的研究进展进行综述。 相似文献
16.
Despite recent advances in the management of colorectal cancer, metastatic disease remains challenging, and patients are rarely cured. However, a better understanding of the pathways implicated in the evolution and proliferation of cancer cells has led to the development of targeted therapies, that is, agents with action directed at these pathways/features. This approach is more specific to cells within which these pathways, such as epidermal growth factor receptor (EGFR), are overactive; this is in contrast to the relatively indiscriminate mechanism by which cytotoxic chemotherapy tends to affect rapidly dividing cells, regardless of their role. Although factors unique to a given patient, such as the location of the primary tumor (sidedness) or the presence of mutations that confer resistance, may limit the utility of these agents, targeted therapies are now a part of the treatment paradigm for metastatic colorectal cancer, and survival outcomes have significantly improved. This review provides an overview of the role of targeted therapy in the management of patients with colorectal cancer metastases as well as a discussion of issues in patient selection, with a focus on inhibitors of angiogenesis, EGFR-targeted therapy, BRAF mutation–targeted therapies, and other novel strategies, including immunotherapy. 相似文献
17.
目的:系统评价贝伐单抗(bevacizumab, BEV)联合化疗一线治疗转移性结直肠癌的有效性和安全性.方法:利用计算机检索PubMed、Embase、Cochrane图书馆、中国期刊全文数据库、中国生物医学文献数据库和中文科技期刊全文数据库中的BEV联合化疗一线治疗转移性结直肠癌的随机对照试验,对纳入研究的方法学质量进行评价,并进行荟萃分析.结果:共纳入6篇文献,包括2 646名患者.荟萃分析结果显示,BEV联合化疗组的有效率(完全缓解+部分缓解)较高(相对危险度为1.27,95%的可信区间为1.00~1.61,P= 0.05),且中位生存时间和无进展生存(progression-free survival, PFS)时间延长.治疗组与对照组总的3/4级不良反应、3/4级高血压、不良反应所致研究中止以及胃肠穿孔发生率的差异均有统计学意义,其相对危险度(95%的可信区间)分别为1.12(1.07~1.61)、4.51(2.81~7.23)、1.37(1.16~1.63)和4.32(1.24~15.05);而3/4级出血、60 d全因死亡率、3/4级蛋白尿、3/4级腹泻、3/4级白细胞减少和肺栓塞的发生率差异则无统计学意义,其相对危险度(95%的可信区间)分别为1.50(0.87~2.57)、0.71(0.45~1.11)、2.26(0.69~7.33)、1.18(0.99~1.41)、1.17(0.97~1.42)和0.84(0.46~1.53). 结论:BEV联合化疗一线治疗转移性结直肠癌可提高有效率,延长PFS和中位生存时间,但总的3/4级不良反应、3/4级高血压和胃肠穿孔的发生率较高. 相似文献
18.
During the last decade, the development of new drugs known as targeted therapies was the result of a better understanding
of the processes involved in the transformation of normal cells into cancer. The term targeted therapy refers to drugs that
selectively target specific molecular pathways involved in tumorigenesis or tumour progression. Angiogenesis is important
for tumour growth and metastasis, and is an important target for new biological agents. Bevacizumab is a humanised recombinant
antibody that prevents vascular endothelial growth factor (VEGF) receptor binding, and inhibits angiogenesis and tumour growth.
On February 26, 2004, the Food and Drug Administration approved bevacizumab as first-line treatment for patients with metastatic
colorectal cancer (CRC). The integration of targeted therapies in the treatment of colon cancer has resulted in significant
improvements in efficacy outcomes. The efficacy of bevacizumab in the treatment of metastatic CRC is presented in this review
article. 相似文献
19.
Introduction: Colorectal cancer is a significant global health issue with over 1 million cases diagnosed annually throughout the world. 15% of patients diagnosed with colorectal cancer will have liver metastases and 60% will develop liver metastases if they have metastatic disease. Oligometastatic colorectal cancer confined to the liver represents an intermediate state in the evolution of metastatic capacity that opens the opportunity for local interventions. Areas covered: The literature supports long-term survival if patients undergo liver resection of colorectal metastases. This article reviews the liver-directed therapeutic strategies available for the management of metastatic liver disease including hepatic arterial infusion therapy, radiofrequency ablation, radiation therapy and transarterial chemoembolization. Expert commentary: Great advances have been made with the use of liver directed therapies. In the USA using hepatic arterial infusions with FUDR and Decadron along with systemic therapy, 5 year survivals after liver resection have improved. In Europe with the use of HAI of Oxaliplatin, more patients have been able to get to resection and have obtained higher survival rates, even in second line therapy. New advances in ablative therapy have improved results to get all disease treated at resection for the treatment of reccurrence 相似文献
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