ASCO2011结直肠癌的学习资料.pptxVIP

ASCO2011结直肠癌的学习资料第1页/共70页 ASCO 2011- Updates in Colorectal Cancer -第2页/共70页 Noteworthy at ASCO for CRC?No practice-changing information, but confirmation of standards of careEarly rectal cancer:Capecitabine can be used as radiosensitizer in neoadjuvant therapyAddition of oxaliplatin more toxic, no increase in pCR rateIs there a role for TNT (Total Neoadjuvant Therapy)?第3页/共70页 Noteworthy at ASCO for CRC?Early colon cancer:Value of oxaliplatin as adjuvant therapy in stage II cancers debatable Palliative therapy of CRC:IGF-R1 inhibitors conclusively ineffectiveNot all KRAS mutations are created equalAflibercept (VEGF-TRAP) is active and improves OS in 2nd line added to FOLFIRI(to be presented in Barcelona)第4页/共70页 The Impact of Capecitabine and Oxaliplatin in the Preoperative Multimodality Treatment of Patients with Carcinoma of the Rectum: NSABP R-04MS Roh, GA Yothers, MJ OConnell, RW Beart, HC Pitot, AF Shields, DS Parda, S Sharif, CJ Allegra, NJ Petrelli, JC Landry, DP Ryan, A Arora, TL Evans, GS Soori,L Chu, RV Landes, M Mohiuddin, S Lopa, N Wolmark1400 Patients第5页/共70页 Compare the rate of local-regional relapse in patients receiving preoperative capecitabine with RT to patients receiving preoperative CVI 5-FU with RTCompare the rate of local-regional relapse in patients receiving preoperative oxaliplatin with those not receiving preoperative oxaliplatinNSABP R-04 Primary AimsRoh et al. ASCO 2011第6页/共70页 Group 4Capecitabine 825 mg/m2 PO BID + Oxaliplatin 50 mg/m2/week X 5+4600cGy + 540-1080cGyAdenocarcinoma of rectum amenable to surgical resection located 12 cm from anal vergeSTRATIFICATIONGenderClinical Tumor Stage II or IIIIntent for Type of Surgery (sphincter saving; non-sphincter saving)RANDOMIZATIONGroup 3Capecitabine 825 mg/m2 PO BID +4600cGy + 540-1080cGyGroup 25FU (CVI 225mg/m2 5d/week) + Oxaliplatin 50 mg/m2/week X 5 +4600cGy + 540-1080cGyGroup 15FU (CVI 225mg/m2 5d/week)+4600cGy + 540-1080cGySURGERYRoh et al. ASCO 2011第7页/共70页 Gastrointestinal Toxici