晚期大肠癌靶向治疗新进展课件.pptVIP

晚期大肠癌靶向治疗新进展 MACRO:贝伐珠单抗维持治疗一线治疗晚期 大肠癌 2. COIN:西妥昔单抗联合奥沙利铂为基础的化疗 治疗晚期大肠癌 疗 效 分 析 结 论 谢 谢！ Importantly, both regimens were well tolerated, with 53% of XELIRI-treated patients experiencing at least one grade 3/4 event, compared with 48% of FOLFIRI-treated patients. Neutropenia was more common in the FOLFIRI + Avastin arm (23%) than in the XELIRI arm (15%). Rates of grade 3 diarrhoea were low in both arms, but higher with XELIRI (11%) than with FOLFIRI (5%). Grade 4 diarrhoea was seen in only 1% of patients in the XELIRI arm. * * Thank you to the ASCO programme committee for the opportunity to present the results of the MRC COIN trial of first line therapy in metastatic colorectal cancer patients I am presenting on behalf of me colleagues across the UK and the republic of Ireland and the 2445 patients and families who participated in this trial, the largest ever conducted in this disease setting. * The primary endpoint of the cetuximab question is overall survival The emergence of randomised data indicating that the benefit of EGFR targeted monoclonal antibodies is limited to those with kras wildtype tumours, occurred just after the last patient had entered the study and prior to any analysis. The primary endpoint was then adjusted to improved overall survival in the Kras wildtype population. Secondary endpoints are as shown * Response rate was improved in the kras wt population with the addition of cetuximab from 57% to 64%; whereas in the kras mutation group, no improvement was sen nwith lower response rates overall 46% in Arm A and 43% in arm B. Note all responses were investigator assessed and no confirmatory scans were performed. * In light of the other positive trials in this setting we undertook a number of prespecified subgroup analyses to try to understand why the overall results were negative even in the wildtype patients. To maximise the sensitivity of these analyses we used the all wild-type group with PFS as the endpoint. Two subgroups showed s