内容紹介
Retrospective Analysis of the Bevacizumab and CapeOX Combination in Untreated Metastatic/Recurrent Colorectal Cancer
Summary
In recent years, there has been significant progress in systemic chemotherapy for metastatic or recurrent colorectal cancer. We investigated the clinical efficacy and feasibility of the bevacizumab and capecitabine/oxaliplatin(CapeOX)combination for untreated colorectal cancer. From October 2009 to June 2012, 38 patients were included, 18 receiving CapeOX alone and 20 receiving CapeOX plus bevacizumab. The response rate and disease-control rate were 16% and 50%, respectively, in the CapeOX arm, and 55% and 85%, respectively, in the CapeOX plus bevacizumab arm. Median progression-free survival was 8.0 months in the CapeOX arm and 12.8 months in CapeOX plus bevacizumab arm. The median overall survival was 21.6 months in the CapeOX arm and 34.0 months in CapeOX plus bevacizumab arm. Our results suggest that CapeOX treatment can be useful in the outpatient setting and more effective when combined with bevacizumab. Except in cases of bevacizumab intolerance, addition of bevacizumab to CapeOX treatment is considered useful as first-line therapy for metastatic or recurrent colorectal cancer.
要旨
進行・再発大腸癌に対する化学療法は進歩してきている。今回,2009年10月～2012年6月まで当科で治療した進行・再発大腸癌患者の一次治療としてCapeOX療法とCapeOX療法にbevacizumab(BV)を併用した際の有効性,安全性をretrospectiveに検討した。解析対象の全38例中CapeOX療法(A群)は18例,CapeOX+BV療法(B群)は20例に施行された。A群の奏効率16%,B群の奏効率は55%であり,BV併用群でより高い奏効率を認めた。PFS中央値はA群8.0か月(95% CI: 3.0-16.5),B群12.8か月(95% CI: 6.4-NR)であった(HR: 0.60,log-rank検定,p=0.1980,Wilcoxon検定,p=0.0928)。OS中央値はA群21.6か月(95% CI: 9.6-NR),B群は34.0か月(95% CI: 13.2-NR)であった(HR: 0.40,log-rank検定,p=0.1089,Wilcoxon検定,p=0.0687)。CapeOX療法は3週ごとの外来通院で投与可能であり,患者の通院にかかる負担の軽減が期待される。BVに不適な症例を除き,CapeOX+BV療法は,進行・再発大腸癌の一次治療として有用性の高い併用療法であると考えられた。
目次
Summary
In recent years, there has been significant progress in systemic chemotherapy for metastatic or recurrent colorectal cancer. We investigated the clinical efficacy and feasibility of the bevacizumab and capecitabine/oxaliplatin(CapeOX)combination for untreated colorectal cancer. From October 2009 to June 2012, 38 patients were included, 18 receiving CapeOX alone and 20 receiving CapeOX plus bevacizumab. The response rate and disease-control rate were 16% and 50%, respectively, in the CapeOX arm, and 55% and 85%, respectively, in the CapeOX plus bevacizumab arm. Median progression-free survival was 8.0 months in the CapeOX arm and 12.8 months in CapeOX plus bevacizumab arm. The median overall survival was 21.6 months in the CapeOX arm and 34.0 months in CapeOX plus bevacizumab arm. Our results suggest that CapeOX treatment can be useful in the outpatient setting and more effective when combined with bevacizumab. Except in cases of bevacizumab intolerance, addition of bevacizumab to CapeOX treatment is considered useful as first-line therapy for metastatic or recurrent colorectal cancer.
要旨
進行・再発大腸癌に対する化学療法は進歩してきている。今回,2009年10月～2012年6月まで当科で治療した進行・再発大腸癌患者の一次治療としてCapeOX療法とCapeOX療法にbevacizumab(BV)を併用した際の有効性,安全性をretrospectiveに検討した。解析対象の全38例中CapeOX療法(A群)は18例,CapeOX+BV療法(B群)は20例に施行された。A群の奏効率16%,B群の奏効率は55%であり,BV併用群でより高い奏効率を認めた。PFS中央値はA群8.0か月(95% CI: 3.0-16.5),B群12.8か月(95% CI: 6.4-NR)であった(HR: 0.60,log-rank検定,p=0.1980,Wilcoxon検定,p=0.0928)。OS中央値はA群21.6か月(95% CI: 9.6-NR),B群は34.0か月(95% CI: 13.2-NR)であった(HR: 0.40,log-rank検定,p=0.1089,Wilcoxon検定,p=0.0687)。CapeOX療法は3週ごとの外来通院で投与可能であり,患者の通院にかかる負担の軽減が期待される。BVに不適な症例を除き,CapeOX+BV療法は,進行・再発大腸癌の一次治療として有用性の高い併用療法であると考えられた。