课件：ASCO直肠癌围手术期治疗进展探究.ppt

主要内容 教育专场：局部进展期直肠癌（LARC）是时候改变了吗 口头报告：FOWARC研究 壁报讨论：JFMC35-C1: ACTS-RC，veliparib combined with capecitabine，S0713 普通壁报 3609: A phase II single arm feasibility trial of neoadjuvant chemotherapy (NAC) with oxaliplatin/fluorouracil (OxMdG) then short-course preoperative radiotherapy (SCPRT) then immediate surgery in operable rectal cancer (ORC): COPERNICUS (NC. Results:?60 UK pts ypT0ypN0 in 7/57 pts (12%) 3607: A phase II study of 5-fluorouracil (5-FU), ziv-aflibercept, and radiation for the preoperative and adjuvant treatment of patients (pts) with stage II/III rectal cancer. Results:?N=39 8 pts (25%) achieved pCR, 3592: Phase II trial of preoperative radiation with concurrent capecitabine, oxaliplatin, and bevacizumab followed by surgery and postoperative 5-fluorouracil, leucovorin, oxaliplatin (FOLFOX), and bevacizumab in patients with locally advanced rectal cancer: 5-year clinical outcomes of a trial of the ECOG-ACRIN Cancer Research Group (E3204). 研究方案 57例可切除的T3/T4直肠腺癌 术前放化疗： 卡培他滨825 奥沙利铂50 贝伐单抗5，D1、15、29 RT 50.4Gy 手术：新辅助8周后 术后8-12周：FOLFOX联合贝伐单抗12周期 结果 5年OS：80% 5年PFS：81% 2例复发 3569: Phase I study of preoperative chemoradiation with temozolomide and capecitabine in patients with locally advanced rectal cancer. 研究设计 放疗剂量：45Gy/25fr QD，再推量5.4Gy/3fr 卡培他滨：825mg/m2 BID 替莫唑胺：1级-45、2级-60、3级-75mg/m2 QD MGMT甲基化检测：甲基特异性PCR * 结果 2013年5月-2014年4月：22例患者 总pCR：31.8%（7/22） MGMT甲基化：72.7%（16/22） 亚组pCR：MGMT甲基化组：37.5%（6/16） MGMT非甲基化组：16.7%（1/6） p=0.62 结论 替莫唑胺推荐剂量：75mg/m2 QD 耐受性良好 MGMT甲基化组pCR率稍高 需进一步研究证实 ganetespib+capecitabine HSP 90抑制剂 N=12 pCR25% TPS3626: Induction mFOLFOX6 with or without aflibercept followed by chemoradiation (CRT) and surgery in high risk rectal cancer: Phase II randomized, multicenter, openlabel trial—The GEMCAD RIA study. Enrollment began in January 2015. ClinicalT Identifier: NCClinical trial information: 总结 如何减少远处转移是局部进展期直肠癌的研究重点 单纯化疗是趋势，值得进一步探索和加强 更多的药物将整合进入直肠癌的新辅助治疗 * Third，