结直肠癌新观点Marshall-colon overview-CH.pptVIP

2010 NCCN 指南 * When you compare the pooled PFS general and on treatment analysis you can observe that both Avastin curves separate nicely in the begining but the PFS general Avastin curve starts to run parallel around 6 month. This reflects the observed phenomenon that a large group of patients in the 966 trial discontinued treatment at 6 month and was not treated until progression, as recommended in the protocol. * * sample size refres to IIT population. Check demographics etc to see if all are PP * * * * * * * * Figure 2. Kaplan-Meier Estimates of Overall Survival among Patients with Stage II or Stage III Colon Cancer According to Treatment Status. Patients with tumors exhibiting microsatellite stability or low-frequency microsatellite instability who received adjuvant chemotherapy had a significant increase in overall survival as compared with patients who received no adjuvant chemotherapy (hazard ratio for death, 0.69 [95 percent confidence interval, 0.50 to 0.94]; P=0.02) (Panel A). Among patients with tumors exhibiting high-frequency microsatellite instability, there was no significant difference in the duration of overall survival between patients who received adjuvant chemotherapy and those who did not (hazard ratio for death, 2.17 [95 percent confidence interval, 0.84 to 5.55]; P=0.10) (Panel B). The analysis included data for eight years from the date of randomization. * How might this relate to cetuximab and Stage III colon cancer? Again, you see the EMT process, with the epithelial cells expressing EGFR and other epithelial biomarkers, which the mesenchymal cells lose. The mesenchymal phenotype is associated with the acquisition of different molecular properties, some of which are shown here. Importantly some of the molecular properties associated with the mesenchymal phenotype are defined by validated or potentially druggable targets. * * * * * * * * * Xeloda is firmly established as first-line treatment for MCRC, leading to the question, ‘Can Xeloda