晚期大肠癌的个体化治疗演示幻灯片.pptVIP

Permission to include this figure in this CCO activity was granted by Eric Van Cutsem, MD, PhD. CRYSTAL: Initial and Retrospective Results The primary endpoint of the CRYSTAL study was met for the overall population [Van Cutsem ASCO 2007/abs 4000, slide 13, 14] The efficacy of ERBITUX was reduced in the subpopulation of patients with tumors bearing KRASmut [Van Cutsem ASCO 2008/abs 2, slide 22] The PFS and Response rates were increased in patients with wild type KRAS tumors [Van Cutsem ASCO 2008/slides 12, 15] References Van Cutsem E, Nowacki M, Lang I, et al. Randomized phase III study of irinotecan and 5-FU/FA with or without cetuximab ins the first-line treatment of patients with metastatic colorectal cancer (mCRC): the CRYSTAL trial. J Clin Oncol. 2007 ASCO Annual Meeting Proceedings Part I. 2007;25(18S):Abstr 4000. Van Cutsem E, Lang I, D’haens G, et. al. KRAS status and efficacy in the first-line treatment of patients with metastatic colorectal cancer (mCRC) treated with FOLFIRI with or without cetuximab: the CRYSTAL experience. J Clin Oncol. 26:2008(May 20 Suppl);abstr 2. OPUS: Initial and Retrospective Results There was a difference in ORR with the addition of ERBITUX to FOLFOX for the overall population (primary endpoint) [Bokemeyer ASCO 2007/abs 4035, slide 4] The efficacy of ERBITUX was reduced in the subpopulation of patients with tumors bearing K-RASmut [Bokemeyer ASCO 2008/slides 14, 16] The efficacy of ERBITUX was increased in the subpopulation of patients with tumors bearing the K-RASwt, with a 43% reduction in the risk of progression and a relative 65% improvement in RR [Bokemeyer ASCO 2008/slides 13, 15] CAIRO2 Summary Cetuximab + bevacizumab/capecitabine/oxaliplatin decreased PFS without affecting OS Although manageable, cetuximab + bevacizumab/ chemotherapy increases skin toxicity and diarrhea adverse events Treatment discontinuation due to toxicity did not differ between arms Negative interaction between anti-VEGF and anti-EGFR cannot be