结肠癌靶向治疗进展.pptxVIP

结肠癌靶向治疗进展;第2页/共63页;第3页/共63页;第4页/共63页;第5页/共63页;;贝伐单抗;第8页/共63页;第9页/共63页;贝伐单抗适应症;贝伐单抗在II/III期结直肠癌中的应用价值？;;;NCCN;贝伐单抗在IV期结直肠癌中的应用价值？;;第17页/共63页;第18页/共63页;;;第21页/共63页;第22页/共63页;第23页/共63页;第24页/共63页;Bevacizumab in Combination With Oxaliplatin-Based Chemotherapy As First-Line Therapy in Metastatic Colorectal Cancer: A Randomized Phase III Study;Bevacizumab in Combination With Oxaliplatin-Based Chemotherapy As First-Line Therapy in Metastatic Colorectal Cancer: A Randomized Phase III Study;贝伐单抗在IV期结直肠癌中推荐一线使用;Anti-EGFR ;EGFR Signaling Pathway in Colorectal Carcinoma ;西妥昔单抗/帕尼单抗;西妥昔/帕尼单抗在II/III期结直肠癌中的应用价值？;第32页/共63页;;;西妥昔单抗未能给III期结肠癌辅助治疗带来生存获益，N0147试验结果为阴性 ;由于抗EGFR治疗在Ⅰ/Ⅱ/Ⅲ期结肠癌的治疗中并无作用，因此不推荐在这些早期患者进行KRAS 测定;西妥昔/帕尼单抗在IV期结直肠癌中的应用价值？;;;;第41页/共63页;;第43页/共63页;西妥昔或帕尼单抗在IV期KRAS野生型结直肠癌中推荐一线使用;BRAF基因检测在结直肠癌中的应用价值？;Wild-Type BRAF Is Required for Response to Panitumumab or Cetuximab in Metastatic Colorectal Cancer;In wild-type KRAS patients, those carrying a BRAF-mutated tumor had a shorter PFS and OS than wild-type BRAF patients;Cetuximab plus FOLFIRI: Final data from the CRYSTAL study on the association of KRAS and BRAF biomarker status with treatment outcome ;1.有些回顾性的证据表明BRAF 突变是转移性结直肠癌非一线治疗中对抗EGFR 治疗耐药的另外一个标志； 2.在一线治疗中将抗EGFR 制剂加入到FOLFOX 或FOLFIRI 化疗中，可能仍然会给V600E BRAF 突变者带来一些生存获益 ;VEGF单抗与EGFR单抗联合使用的价值？;Chemotherapy, Bevacizumab, and Cetuximab in Metastatic Colorectal Cancer;A Randomized Phase IIIB Trial of Chemotherapy, Bevacizumab, and Panitumumab Compared With Chemotherapy and Bevacizumab Alone for Metastatic Colorectal Cancer;A Randomized Phase IIIB Trial of Chemotherapy, Bevacizumab, and Panitumumab Compared With Chemotherapy and Bevacizumab Alone for Metastatic Colorectal Cancer;这两个III期临床试验表明一种以上的生物靶向制剂联合应用并没提高疗效，反而增加了治疗毒性。 因此，目前专家组强烈反对同时应用贝伐珠单抗和西妥昔单抗或帕尼单抗。 ;VEGF单抗与EGFR单抗非一线使用中的价值？;Bevacizumab in Combination With Oxaliplatin, Fluorouracil, and Leucovorin (FOLFOX4) for Previously Treated Metastatic Colorectal Cancer: Results From the Eastern Cooperative Oncology Group Study E