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Поддерживающая терапия при метастатическом колоректальном раке: один из вариантов выбора или новый стандарт лечения?
Поддерживающая терапия при метастатическом колоректальном раке: один из вариантов выбора или новый стандарт лечения?
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Аннотация
В статье рассматриваются исследования по оценке оптимальной продолжительности 1-й линии химиотерапии метастатического колоректального рака. Показано, что поддерживающая стратегия имеет преимущества перед полным прерыванием лечения. Бевацизумаб – в монорежиме или в комбинации с фторпиримидинами – может успешно применяться в поддерживающем режиме. При прогрессировании целесообразно продолжить бевацизумаб во 2-й линии химиотерапии.
Ключевые слова: метастатический колоректальный рак, поддерживающая терапия, бевацизумаб.
Its maintenance strategy is shown to have advantages over complete treatment interruption. Bevacizumab as monotherapy or as part of combination therapy with fluoropyrimidines may be successfully used in a maintaining regimen. In case of progression, it is expedient to continue bevacizumab during second-line chemotherapy.
Key words: metastatic colorectal cancer, maintenance therapy, bevacizumab.
Ключевые слова: метастатический колоректальный рак, поддерживающая терапия, бевацизумаб.
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Its maintenance strategy is shown to have advantages over complete treatment interruption. Bevacizumab as monotherapy or as part of combination therapy with fluoropyrimidines may be successfully used in a maintaining regimen. In case of progression, it is expedient to continue bevacizumab during second-line chemotherapy.
Key words: metastatic colorectal cancer, maintenance therapy, bevacizumab.
Полный текст
Список литературы
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2. Myers MH, Gloeckler LA. Cancer patients survival rates. CA 1989; 39: 21.
3. Wingo PA, Tong T, Bolden S. Cancer statistics. CA 1995; 45: 8–30.
4. Weitz J, Koch M, Debus J et al. Colorectal cancer. Lancet 2005; 365: 153–65.
5. Grothey А, Sargent D, Goldberg RM et al. Survival of patients with advanced colorectal cancer improves with the availability of fluorouracil-leucovorin, irinotecan, and oxaliplatin in the course of treatment. J Clin Oncol 2004; 22: 1209–14.
6. Toxicity of fluorouracil in patients with advanced colorectal cancer: effect of administration schedule and prognostic factors. Meta-Analysis Group In Cancer. J Clin Oncol 1998; 16 (11): 3537–41.
7. Saltz LB, Clarke S, Díaz-Rubio E et al. Bevacizumab in combination with oxaliplatin-based chemotherapy as first-line therapy in metastatic colorectal cancer: A randomized phase III study. JCO 2008; 26: 2012–9.
8. Cassidy J, Clarke S, Díaz-Rubio E et al. XELOX vs FOLFOX-4 as first-line therapy for metastatic colorectal cancer: NO16966 updated results. Br J Cancer 2011; 105 (1): 58–64.
9. Grothey A. A comparison of XELOX with FOLFOX-4 as first-line treatment for metastatic colorectal cancer. Nat Clin Pract Oncol 2009; 6 (1): 10–1.
10. Tournigand C, André T, Achille E et al. FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a randomized GERCOR study. J Clin Oncol 2004; 22 (2): 229–37.
11. Jordan K, Kellner O, Kegel T et al. Phase II trial of capecitabine/irinotecan and capecitabine/oxaliplatin in advanced gastrointestinal cancers. Clin Colorectal Cancer 2004; 4 (1): 46–50.
12. Goldberg RM, Sargent DJ, Morton RF et al. A randomized controlled trial of fluorouracil plus leucovorin, irinotecan, and oxaliplatin combinations in patients with previously untreated metastatic colorectal cancer. J Clin Oncol 2004; 22: 23–30.
13. Falcone A, Ricci S, Brunetti I et al. Phase III trial of infusional fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) compared with infusional fluorouracil, leucovorin, and irinotecan (FOLFIRI) as first-line treatment for metastatic colorectal cancer: the Gruppo Oncologico Nord Ovest. J Clin Oncol 2007; 25 (13): 1670–6.
14. Tournigand C, Cervantes A, Figer A et al. OPTIMOX1: A randomized study of FOLFOX4 or FOLFOX7 with oxaliplatin stop-and-go fashion in advanced colorectal cancer – a GERCOR study. JCO 2006; 24: 394–400.
15. Chibaudel B, Maindrault-Goebel F, Lledo G et al. Can chemotherapy be discontinued in unresectable metastatic colorectal cancer? The GERCOR OPTIMOX2 Study. JCO 2009; 27: 5727–33.
16. Perez-Staub N, Chibaudel, B, Figer A et al. Who can benefit from chemotherapy holidays after first-line therapy for advanced colorectal cancer? A GERCOR study. J Clin Oncol 2008; 26 (Suppl.): 4037.
17. Adams RA, Meade AM, Seymour MT et al. Intermittent versus continuous oxaliplatin and fluoropyrimidine combination chemotherapy for first-line treatment of advanced colorectal cancer: results of the randomised phase 3 MRC COIN trial. Lancet Oncol 2011; 12 (7): 642–53.
18. Maughan TS, Adams RA, Smith CG et al. Addition of cetuximab to oxaliplatin-based first-line combination chemotherapy for treatment of advanced colorectal cancer: results of the randomised phase 3 MRC COIN trial. Lancet 2011; 377 (9783): 2103–14.
19. Labianca R, Sobrero A, Isa L et al. Intermittent versus continuous chemotherapy in advanced colorectal cancer: a randomised ‘GISCAD’ trial. Ann Oncol 2011; 22: 1236–42.
20. Kabbinavar F, Hurwitz HL, Fehrenbacher L et al. Phase II randomized trial comparing bevacizumab plus fluorouracil (FU)/leucovorin (LV) with FU/LV alone in patients with metastatic colorectal cancer. J Clin Oncol 2003; 21: 60.
21. Kabbinavar FF, Schulz J, McCleod M et al. Addition of bevacizumab to bolus fluorouracil and leucovorin in first-line metastatic colorectal cancer: results of a randomized phase II trial. J Clin Oncol 2005; 23: 3697–705.
22. Hurwitz H, Fehrenbacher L, Novotny W et al. Bevacizumab plus irinotecan, fluorouracil and leucovorin for metastatic colorectal cancer. N Engl J Med 2004; 350: 2335–42.
23. Rosen O, Yi J, Hurwitz HI et al. Clinical benefit of bevacizumab in metastatic colorectal cancer is independent of K-ras mutation status: analysis of phase III study of bevacizumab with chemotherapy in previously untreated metastatic colorectal cancer. Ann Oncol 2008; 19 (Suppl. 6): vi 19, abstr 0-035.
24. Hurwitz HI, Yi J, Ince W et al. The clinical benefit of bevacizumab in metastatic colorectal cancer is independent of K-ras mutation status: analysis of phase III study of bevacizumab with chemotherapy in previously untreated metastatic colorectal cancer. Oncologist 2009; 14 (1): 22–8.
25. Saltz LB, Clarke S, Diaz-Rubio E at al. Bevacizumab (Bev) in combination with XELOX or FOLFOX4: efficacy results from XELOX-1/NO16966, a randomized phase III trial in the first-line treatment of metastatic colorectal cancer (MCRC). GI Cancers Symposium, 2007; abstr. 238.
26. Grothey A, Sugrue MM, Purdie DM et al. Bevacizumab beyond first progression is associated with prolonged overall survival in metastatic colorectal cancer: Results from a large observational cohort study (BRiTE). J Clin Oncol 2008; 26: 5326–34.
27. Cohn AL, Bekaii-Saab T, Bendell JC et al. Clinical outcomes in bevacizumab (BV)-treated patients (pts) with metastatic colorectal cancer (mCRC): Results from ARIES observational cohort study (OCS) and confirmation of BRiTE data on BV beyond progression (BBP). J Clin Oncol 2010; 28 (Suppl. 15): 3596.
28. Arnold D, Andre T, Bennouna J et al. Bevacizumab plus chemotherapy continued beyond first progression in patients with metastatic colorectal cancer previously treated with bevacizumab plus chemotherapy: results of randomized phase III intergroup study. J Clin Oncol 2012, 30 (Suppl. 15): abstr. CRA 3503.
29. Grothey A, Hart LL, Rowland KM et al.. Intermittent oxaliplatin (oxali) administration and time-to-treatment-failure (TTF) in metastatic colorectal cancer (mCRC): Final results of the phase III CONcePT trial. JCO 2008; 26 (Suppl. 15): 4010.
30. Yalcin S, Uslu R, Dane F et al. A randomised, multicenter phase III trial of bevacizumab plus capecitabine as maintenance treatment after initial treatment with bevacizumab plus XELOX in previously untreated metastatic colorectal cancer. JCO 2011; 11 (Suppl. 4): 474.
31. Tabernero J, Aranda E, Gomez A et al. Phase III study of first-line XELOX plus bevacizumab (BEV) for 6 cycles followed by XELOX plus bevacizumab or singl-agent (s/a) BEV as maintenance therapy in patients (pts) with metastatic colorectal cancer (mCRC): The MACRO Trial (Spanish Cooperative Group for the Treatment of Digestive Tumors [TTD]). JCO 2010; 28 (Suppl. 15): 3501.
32. Diaz-Rubio E, Gomaz-Espana A, Massuti B et al. First-Line XELOX Plus Bevacizumab Followed by XELOX Plus Bevacizumab or Single-Agent Bevacizumab as Maintenance Therapy in Patients with Metastatic Colorectal Cancer: The Phase III MACRO. Oncologist 2012; 17: 15–25.
33. http://clinicaltrials.gov/ct2/show/NCT00973609. Randomized three arm phase III trial on induction treatment with a fluoropyrimidine-, oxaliplatin- and bevacizumab-based chemotherapy for 24 weeks followed by maintenance treatment with a fluoropyrimidine and bevacizumab vs. bevacizumab alone vs. no maintenance treatment and reinduction in case of progression for first-line treatment of patients with metastatic colorectal cancer.
2. Myers MH, Gloeckler LA. Cancer patients survival rates. CA 1989; 39: 21.
3. Wingo PA, Tong T, Bolden S. Cancer statistics. CA 1995; 45: 8–30.
4. Weitz J, Koch M, Debus J et al. Colorectal cancer. Lancet 2005; 365: 153–65.
5. Grothey А, Sargent D, Goldberg RM et al. Survival of patients with advanced colorectal cancer improves with the availability of fluorouracil-leucovorin, irinotecan, and oxaliplatin in the course of treatment. J Clin Oncol 2004; 22: 1209–14.
6. Toxicity of fluorouracil in patients with advanced colorectal cancer: effect of administration schedule and prognostic factors. Meta-Analysis Group In Cancer. J Clin Oncol 1998; 16 (11): 3537–41.
7. Saltz LB, Clarke S, Díaz-Rubio E et al. Bevacizumab in combination with oxaliplatin-based chemotherapy as first-line therapy in metastatic colorectal cancer: A randomized phase III study. JCO 2008; 26: 2012–9.
8. Cassidy J, Clarke S, Díaz-Rubio E et al. XELOX vs FOLFOX-4 as first-line therapy for metastatic colorectal cancer: NO16966 updated results. Br J Cancer 2011; 105 (1): 58–64.
9. Grothey A. A comparison of XELOX with FOLFOX-4 as first-line treatment for metastatic colorectal cancer. Nat Clin Pract Oncol 2009; 6 (1): 10–1.
10. Tournigand C, André T, Achille E et al. FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a randomized GERCOR study. J Clin Oncol 2004; 22 (2): 229–37.
11. Jordan K, Kellner O, Kegel T et al. Phase II trial of capecitabine/irinotecan and capecitabine/oxaliplatin in advanced gastrointestinal cancers. Clin Colorectal Cancer 2004; 4 (1): 46–50.
12. Goldberg RM, Sargent DJ, Morton RF et al. A randomized controlled trial of fluorouracil plus leucovorin, irinotecan, and oxaliplatin combinations in patients with previously untreated metastatic colorectal cancer. J Clin Oncol 2004; 22: 23–30.
13. Falcone A, Ricci S, Brunetti I et al. Phase III trial of infusional fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) compared with infusional fluorouracil, leucovorin, and irinotecan (FOLFIRI) as first-line treatment for metastatic colorectal cancer: the Gruppo Oncologico Nord Ovest. J Clin Oncol 2007; 25 (13): 1670–6.
14. Tournigand C, Cervantes A, Figer A et al. OPTIMOX1: A randomized study of FOLFOX4 or FOLFOX7 with oxaliplatin stop-and-go fashion in advanced colorectal cancer – a GERCOR study. JCO 2006; 24: 394–400.
15. Chibaudel B, Maindrault-Goebel F, Lledo G et al. Can chemotherapy be discontinued in unresectable metastatic colorectal cancer? The GERCOR OPTIMOX2 Study. JCO 2009; 27: 5727–33.
16. Perez-Staub N, Chibaudel, B, Figer A et al. Who can benefit from chemotherapy holidays after first-line therapy for advanced colorectal cancer? A GERCOR study. J Clin Oncol 2008; 26 (Suppl.): 4037.
17. Adams RA, Meade AM, Seymour MT et al. Intermittent versus continuous oxaliplatin and fluoropyrimidine combination chemotherapy for first-line treatment of advanced colorectal cancer: results of the randomised phase 3 MRC COIN trial. Lancet Oncol 2011; 12 (7): 642–53.
18. Maughan TS, Adams RA, Smith CG et al. Addition of cetuximab to oxaliplatin-based first-line combination chemotherapy for treatment of advanced colorectal cancer: results of the randomised phase 3 MRC COIN trial. Lancet 2011; 377 (9783): 2103–14.
19. Labianca R, Sobrero A, Isa L et al. Intermittent versus continuous chemotherapy in advanced colorectal cancer: a randomised ‘GISCAD’ trial. Ann Oncol 2011; 22: 1236–42.
20. Kabbinavar F, Hurwitz HL, Fehrenbacher L et al. Phase II randomized trial comparing bevacizumab plus fluorouracil (FU)/leucovorin (LV) with FU/LV alone in patients with metastatic colorectal cancer. J Clin Oncol 2003; 21: 60.
21. Kabbinavar FF, Schulz J, McCleod M et al. Addition of bevacizumab to bolus fluorouracil and leucovorin in first-line metastatic colorectal cancer: results of a randomized phase II trial. J Clin Oncol 2005; 23: 3697–705.
22. Hurwitz H, Fehrenbacher L, Novotny W et al. Bevacizumab plus irinotecan, fluorouracil and leucovorin for metastatic colorectal cancer. N Engl J Med 2004; 350: 2335–42.
23. Rosen O, Yi J, Hurwitz HI et al. Clinical benefit of bevacizumab in metastatic colorectal cancer is independent of K-ras mutation status: analysis of phase III study of bevacizumab with chemotherapy in previously untreated metastatic colorectal cancer. Ann Oncol 2008; 19 (Suppl. 6): vi 19, abstr 0-035.
24. Hurwitz HI, Yi J, Ince W et al. The clinical benefit of bevacizumab in metastatic colorectal cancer is independent of K-ras mutation status: analysis of phase III study of bevacizumab with chemotherapy in previously untreated metastatic colorectal cancer. Oncologist 2009; 14 (1): 22–8.
25. Saltz LB, Clarke S, Diaz-Rubio E at al. Bevacizumab (Bev) in combination with XELOX or FOLFOX4: efficacy results from XELOX-1/NO16966, a randomized phase III trial in the first-line treatment of metastatic colorectal cancer (MCRC). GI Cancers Symposium, 2007; abstr. 238.
26. Grothey A, Sugrue MM, Purdie DM et al. Bevacizumab beyond first progression is associated with prolonged overall survival in metastatic colorectal cancer: Results from a large observational cohort study (BRiTE). J Clin Oncol 2008; 26: 5326–34.
27. Cohn AL, Bekaii-Saab T, Bendell JC et al. Clinical outcomes in bevacizumab (BV)-treated patients (pts) with metastatic colorectal cancer (mCRC): Results from ARIES observational cohort study (OCS) and confirmation of BRiTE data on BV beyond progression (BBP). J Clin Oncol 2010; 28 (Suppl. 15): 3596.
28. Arnold D, Andre T, Bennouna J et al. Bevacizumab plus chemotherapy continued beyond first progression in patients with metastatic colorectal cancer previously treated with bevacizumab plus chemotherapy: results of randomized phase III intergroup study. J Clin Oncol 2012, 30 (Suppl. 15): abstr. CRA 3503.
29. Grothey A, Hart LL, Rowland KM et al.. Intermittent oxaliplatin (oxali) administration and time-to-treatment-failure (TTF) in metastatic colorectal cancer (mCRC): Final results of the phase III CONcePT trial. JCO 2008; 26 (Suppl. 15): 4010.
30. Yalcin S, Uslu R, Dane F et al. A randomised, multicenter phase III trial of bevacizumab plus capecitabine as maintenance treatment after initial treatment with bevacizumab plus XELOX in previously untreated metastatic colorectal cancer. JCO 2011; 11 (Suppl. 4): 474.
31. Tabernero J, Aranda E, Gomez A et al. Phase III study of first-line XELOX plus bevacizumab (BEV) for 6 cycles followed by XELOX plus bevacizumab or singl-agent (s/a) BEV as maintenance therapy in patients (pts) with metastatic colorectal cancer (mCRC): The MACRO Trial (Spanish Cooperative Group for the Treatment of Digestive Tumors [TTD]). JCO 2010; 28 (Suppl. 15): 3501.
32. Diaz-Rubio E, Gomaz-Espana A, Massuti B et al. First-Line XELOX Plus Bevacizumab Followed by XELOX Plus Bevacizumab or Single-Agent Bevacizumab as Maintenance Therapy in Patients with Metastatic Colorectal Cancer: The Phase III MACRO. Oncologist 2012; 17: 15–25.
33. http://clinicaltrials.gov/ct2/show/NCT00973609. Randomized three arm phase III trial on induction treatment with a fluoropyrimidine-, oxaliplatin- and bevacizumab-based chemotherapy for 24 weeks followed by maintenance treatment with a fluoropyrimidine and bevacizumab vs. bevacizumab alone vs. no maintenance treatment and reinduction in case of progression for first-line treatment of patients with metastatic colorectal cancer.
Авторы
Е.В.Артамонова
ФГБУ Российский онкологический научный центр им. Н.Н.Блохина РАМН, Москва
ФГБУ Российский онкологический научный центр им. Н.Н.Блохина РАМН, Москва
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