个体化治疗延长转移性结直肠癌患者生存的新标准课件.ppt

PFS/OS in patients treated with FOLFOX4 Piessevaux et al. ASCO GI 2011, Abstract No. 398 Early tumor shrinkage and survival in KRAS wt patients treated with FOLFOX4 + ERBITUX Parameter Tumor shrinkage 20% n=24 ≥20% n=54 PFS Median, months 5.7 11.9 [95% CI] [4.5–6.8] [11.6–12.2] HR 0.24 [95% CI] [0.12–0.49] p-value* 0.0001 OS Median, months 15.7 26.1 [95% CI] [6.2–25.2] [22.8–29.3] HR 0.41 [95% CI] [0.23–0.73] p-value* 0.002 *Log-rank CI, confidence interval; HR, hazard ratio; OS, overall survival; PFS, progression-free survival; wt, wild-type Piessevaux et al. ASCO GI 2011, Abstract No. 398 Early tumor shrinkage and survival in KRAS wt patients treated with FOLFOX4 Parameter Tumor shrinkage 20% n=49 ≥20% n=51 PFS Median, months 7.2 7.2 [95% CI] [5.5–8.9] [6.0–8.4] HR 0.93 [95% CI] [0.55–1.55] p-value* 0.78 OS Median, months 17.8 21.6 [95% CI] [16.1–19.6] [18.3–25.0] HR 0.81 [95% CI] [0.50–1.34] p-value* 0.42 *Log-rank CI, confidence interval; HR, hazard ratio; OS, overall survival; PFS, progression-free survival; wt, wild-type Piessevaux et al. ASCO GI 2011, Abstract No. 398 Conclusions In the OPUS trial, early tumor shrinkage was experienced in 69% of patients with KRAS wt tumors treated with 1st-line FOLFOX4 + ERBITUX In these patients, this early tumor shrinkage translated to a long-term clinical benefit of 26 months median OS In patients treated with FOLFOX4 alone early tumor shrinkage does not confer significant benefit in terms of PFS or OS Based on this and the previous CRYSTAL analysis the association between early tumor shrinkage and better long-term outcome, in patients with KRAS wt tumors, is unrelated to the background chemotherapeutic regimen and appears to be specific for ERBITUX Piessevaux et al. ASCO GI 2011, Abstract No. 398 总结 以治疗目标为出发点的治疗策略可以使患者获益最大化，含有西妥昔单抗的治疗方案能显著控制肿瘤并延长肠癌患者的生存期； 个体化治疗以及疗效预测标记物的筛选已经成为肠癌治疗的主要手段； 早期的肿瘤缩小对于含西妥昔单抗的治疗方案可以预测更佳的治疗结果； * 03/15/2007 * * * * * * * * * * * Background Two prior trials demonstrated added benefit with ox