陈逸恒大肠癌化疗进展课件.ppt

Recent progress of chemotherapy for colorectal cancer Yi-heng Chen The Fist Affiliated Hospital of Guangxi University of Traditional Chinese Medicine Contents Neoadjuvant chemotherapy Metastatic Colorectal Cancer: Liver Metastases: Final results of the EORTC Intergroup randomized phase III study 40983 [EPOC] evaluating the benefit of peri-operative FOLFOX4 chemotherapy for patients with potentially resectable colorectal cancer liver metastases EORTC 40983: Toxicity Good compliance with perioperative chemotherapy Most patients (78.6%) received all 6 cycles of FOLFOX4 Treatment well tolerated Most notable toxicities included grade 3 diarrhea (8.2%), grade 3 sensory neuropathy (2.3%), and grade 3/4 neutropenia (18.1%) No toxic deaths occurred during this time period Slightly more postoperative complications observed in chemotherapy-plus-surgery arm vs surgery-alone arm (25.2% vs 15.9%) Postoperative deaths comparable between arms (1 vs 2 patients) Adjuvant chemotherapy Adjuvant FOLFOX4 in Stage II-III Colon Cancer: Final MOSAIC Trial Results Updated efficacy results of the MOSAIC trial, including survival, with a median follow-up of six years high-risk patients T4 bowel obstruction/perforation poorly differentiated tumors lymphatic/vascular invasion fewer than 12 examined nodes indeterminate or positive margins Chemotherapy for advanced /metastatic disease Optimizing Treatment Sequences: Combination vs Sequential Therapy Chemotherapy holiday? Integration of targeted therapies Combination vs Sequential Therapy CAIRO Study: Sequential compared to combination chemotherapy with capecitabine, irinotecan, and oxaliplatin in advanced colorectal cancer (ACC): A Dutch Colorectal Cancer Group (DCCG) phase III study. CAIRO : Key Messages Combination therapy does not significantly improve OS compared with sequential therapy. Both treatment strategies are valid options for pts with ACC. Chemotherapy holiday? OPTIMOX2: Final results of OPTIM