内容紹介
Outcomes of Cetuximab Combination Chemotherapy in Clinical Practice for Patients with Metastatic Colorectal Cancer
Summary
We aimed to evaluate the reproducibility of cetuximab combination chemotherapy as a standard treatment for patients with metastatic colorectal cancer in our hospital using actual clinical data. This study included 14, 9, and 4 patients who received third-line, second-line, and first-line treatment, respectively. The overall response rate(RR), progression-free survival(PFS), and overall survival(OS)were calculated according to treatment line and were compared with the results of large-scale clinical studies. In patients undergoing third-line treatment, the RR was 14.3%, while the median PFS and OS were 2.9 and 9.6 months, respectively. These results were almost identical to those of the NCIC CTG CO. 17 study. In patients undergoing second-line treatment, the RR was 22.2% and the median PFS and OS were 5.8 and 7.1 months, respectively. These results were not inferior to those of the BOND study. In patients undergoing first-line treatment, partial response was observed in 75% of patients and stable disease was observed in 25% of patients. One patient subsequently underwent surgery. The RR(75%)was equal to that observed in the CRYSTAL study and the OPUS study. Standard treatment using cetuximab combination chemotherapy was found to be reproducible as third-line and second-line treatments in our clinical practice. Few patients received first-line treatment; hence, a larger number of patients will have to be evaluated in the future. Nevertheless, the administration of cetuximab combination chemotherapy may be appropriate as a medical treatment strategy for patients with metastatic colorectal cancer.
要旨
セツキシマブ併用化学療法が標準治療として再現性のあるものなのか,当院の実臨床症例の治療成績を用いて検討した。対象は男性20例,女性7例,平均年齢63歳。三次治療14例,二次治療9例,一次治療4例であった。ライン別に奏効率(RR),無増悪生存期間(PFS),全生存期間(OS)を算出し,大規模臨床試験の成績と対比した。三次治療は12例でCPT-11との併用療法を施行し,CR/PR/SD/PD/NE各々0/2/2/9/1例。RR 14.3%,PFS 2.9か月,OS 9.6か月でNCIC CTG CO. 17試験と比較してほぼ同等であった。二次治療ではFOLFIRIまたはIRISとの併用療法が施行され,CR/PR/SD/PD/NE各々0/2/4/1/2例。RR 22.2%,PFS 5.7か月,OS 7.1か月であり,BOND試験と比較して遜色なかった。一次治療では併用療法はmFOLFOX6とFOLFIRIが2例ずつで,CR 0例,PR 3例,SD 1例。RRは75%でCRYSTALおよびOPUS試験と比較して遜色なく,PRの1例は治癒切除が可能となった。三次および二次治療では,標準治療の再現性が実臨床でも得られている傾向が確認できた。一次治療ではまだ症例数が少ないため今後の蓄積が必要であるが,治癒をめざす症例も含めて治療戦略の一つとして今後も積極的に選択してよい治療法であることが示唆された。
目次
Summary
We aimed to evaluate the reproducibility of cetuximab combination chemotherapy as a standard treatment for patients with metastatic colorectal cancer in our hospital using actual clinical data. This study included 14, 9, and 4 patients who received third-line, second-line, and first-line treatment, respectively. The overall response rate(RR), progression-free survival(PFS), and overall survival(OS)were calculated according to treatment line and were compared with the results of large-scale clinical studies. In patients undergoing third-line treatment, the RR was 14.3%, while the median PFS and OS were 2.9 and 9.6 months, respectively. These results were almost identical to those of the NCIC CTG CO. 17 study. In patients undergoing second-line treatment, the RR was 22.2% and the median PFS and OS were 5.8 and 7.1 months, respectively. These results were not inferior to those of the BOND study. In patients undergoing first-line treatment, partial response was observed in 75% of patients and stable disease was observed in 25% of patients. One patient subsequently underwent surgery. The RR(75%)was equal to that observed in the CRYSTAL study and the OPUS study. Standard treatment using cetuximab combination chemotherapy was found to be reproducible as third-line and second-line treatments in our clinical practice. Few patients received first-line treatment; hence, a larger number of patients will have to be evaluated in the future. Nevertheless, the administration of cetuximab combination chemotherapy may be appropriate as a medical treatment strategy for patients with metastatic colorectal cancer.
要旨
セツキシマブ併用化学療法が標準治療として再現性のあるものなのか,当院の実臨床症例の治療成績を用いて検討した。対象は男性20例,女性7例,平均年齢63歳。三次治療14例,二次治療9例,一次治療4例であった。ライン別に奏効率(RR),無増悪生存期間(PFS),全生存期間(OS)を算出し,大規模臨床試験の成績と対比した。三次治療は12例でCPT-11との併用療法を施行し,CR/PR/SD/PD/NE各々0/2/2/9/1例。RR 14.3%,PFS 2.9か月,OS 9.6か月でNCIC CTG CO. 17試験と比較してほぼ同等であった。二次治療ではFOLFIRIまたはIRISとの併用療法が施行され,CR/PR/SD/PD/NE各々0/2/4/1/2例。RR 22.2%,PFS 5.7か月,OS 7.1か月であり,BOND試験と比較して遜色なかった。一次治療では併用療法はmFOLFOX6とFOLFIRIが2例ずつで,CR 0例,PR 3例,SD 1例。RRは75%でCRYSTALおよびOPUS試験と比較して遜色なく,PRの1例は治癒切除が可能となった。三次および二次治療では,標準治療の再現性が実臨床でも得られている傾向が確認できた。一次治療ではまだ症例数が少ないため今後の蓄積が必要であるが,治癒をめざす症例も含めて治療戦略の一つとして今後も積極的に選択してよい治療法であることが示唆された。