[临床医学]晚期肠癌化疗优化选择.ppt

NCCN指南明确指出维持治疗的价值 SFDA未批准希罗达在结直肠癌中联合化疗的适应症 维持治疗的目标 Waddell T, Gollins S, Soe W, et al. Phase Ⅱ study of short-course capecitabine plus oxaliplatin (XELOX) followed by maintenance capecitabine in advanced colorectal cancer: XelQuali study [J]. Cancer Chemotherapy and Pharmacology, 2010, 5(67): 1111 - 7. 主要终点 PFS 次要终点 有效率 顺应性 总生存时间 XelQuali研究: XELOX序贯卡培他滨单药治疗 SFDA未批准希罗达在结直肠癌中联合化疗的适应症 维持治疗让晚期结直肠癌患者进一步获益 Waddell T, Gollins S,Soe W, et al. Phase II study of short-course capecitabine plus oxaliplatin (XELOX) followed by maintenance capecitabine in advanced colorectal cancer: XelQuali study. Cancer Chemother Pharmcol. 2011; 67(5): 1111-7. SFDA未批准希罗达在结直肠癌中联合化疗的适应症 卡培他滨单药序贯治疗阶段，不良反应发生率明显下降 药物对患者的神经毒性、消化道反应、血液学毒性进一步降低 Waddell T, Gollins S, Soe W, et al. Phase Ⅱ study of short-course capecitabine plus oxaliplatin (XELOX) followed by maintenance capecitabine in advanced colorectal cancer: XelQuali study [J]. Cancer Chemotherapy and Pharmacology, 2010, 5(67): 1111 - 7. XELOX方案序贯卡培他滨维持治疗，无严重不良反应发生 SFDA未批准希罗达在结直肠癌中联合化疗的适应症 Li YH, Luo HY, Wang FH, et al. Phase Ⅱ study of capecitabine plus oxaliplatin (XELOX) as first-line treatment and followed by maintenance of capecitabine in patients with metastatic colorectal cancer [J]. Journal of Cancer Research and Clinical Oncology, 2010, 4(136): 503 - 10. 中山大学肿瘤医院关于希罗达维持治疗的研究 SFDA未批准希罗达在结直肠癌中联合化疗的适应症 依据指南推荐，氟尿嘧啶类与靶向药物可作为维持治疗的选择 考虑因素 5-FU 卡培他滨 靶向药物 生活质量 ? ? ? 疗效 ? ? ? 安全 ? ? ? 方便 ? ? ? 价格 ? ? ? 维持治疗药物的选择的考虑因素 SFDA未批准希罗达在结直肠癌中联合化疗的适应症 维持治疗小结 间歇化疗安全性优于持续给药方法, 且疗效相似 维持治疗直至疾病进展能进一步提高患者生存获益 卡培他滨维持治疗作用肯定，患者生活质量不受影响。是维持治疗药物的理想选择 SFDA未批准希罗达在结直肠癌中联合化疗的适应症 总结 SFDA未批准希罗达在结直肠癌中联合化疗的适应症 Thank You! * * * * * OS was examined in several pivotal phase 3 trials in the first-line treatment of patients with unresectable MCRC using CT. The following trials compared the addition of various CT agents to 5-FU/LV with 5-FU/LV alone: In the de Gramont trial, the addition of oxaliplatin to 5-FU/LV (FOLFOX4) did not result in a significant improvement in OS (media