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Efficacy and safety of first-line chemotherapy plus bevacizumab in patients with metastatic colorectal cancer： a meta-analysis

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Chinese Medical Journal 2014年第3期127卷 538-546页

作者： Wang Ming Zheng Xiaofeng Ruan Xiaojiao Ye Bailiang Cai Long Lin Feizhuan Tu Jinfu Jiang Feizhao Li Shaotang Department of Laparoscopic Surgery First Affiliated Hospital of Wenzhou Medical University Wenzhou Zhejiang 325000 China

Background What benefits and toxicities patients acquire from the use of bevacizumab combined with first-line chemotherapy remains controversial.This study was performed to evaluate the efficacy and safety of first-line chemotherapy plus bevacizumab in patients with metastatic colorectal cancer （mCRC）.Methods Several databases,including PubMed,Embase,and Cochrane Library,were searched up to April 30,2013.Eligible studies were only randomized,controlled trials （RCTs） with a direct comparison between mCRC patients treated with and without bevacizumab.Overall risk ratio （RR）,hazard ratio （HR）,odds ratio （OR）,and 95％ confidence intervals （CO were calculated employing fixed or random-effects models depending on the heterogeneity of the included trials.Results Six RCTs,including 1582 patients in chemotherapy plus bevacizumab group and 1484 patients in chemotherapyalone group,were included.Overall,the addition of bevacizumab to first-line chemotherapy increased overall response rate （ORR） by 4.5％,prolonged both progression-free survival （PFS） and overall survival （OS）,and increased the rate of total Grades 3 or 4 adverse events （G3/4AEs） by 6.9％.Significant differences were found in ORR （RR=1.22 （95％ CI 1.01-1.46）,P=0.03）,PFS （HR=0.60 （95％ Cl 0.47-0.77）,P ＜0.0001）,OS （HR=0.83 （95％ Cl 0.70-0.97）,P=0.02）,and any G3/4AEs （OR=1.56 （95％ Cl 1.29-1.89）,P ＜0.00001）.Conclusion Bevacizumab is a valuable addition to the current first-line chemotherapy regimens used in patients with mCRC,because of conferring a significant improvement in ORR,PFS,and OS,even though it increased adverse events.

关键词： antiangiogenesis bevacizumab metastatic colorectal cancer first-line chemotherapy meta-analysis

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Serum basic fibroblast growth factor and interleukin-1βpredict the effect of first-line chemotherapy in patients with advanced gastric cancer

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世界临床病例杂志 2023年第26期11卷 6083-6090页

作者： Li Zheng Li-Hong Gan Ling Yao Bin Li Ya-Qin Huang Fu-Bao Zhang Meng-Qi Kuang Nian Fang Department of Gastroenterology The First Hospital of NanchangNanchang 330008Jiangxi ProvinceChina Department of Stomatology The First Hospital of NanchangNanchang 330008Jiangxi ProvinceChina

BACKGROUND The incidence and mortality rates of gastric cancer in China are the second-highest in the world,and most patients with gastric cancer lose their chance of surgery by the time of their diagnosis.AIM To explore the predictive potential of serum basic fibroblast growth factor and interleukin-1βlevels for the effect of first-line chemotherapy in patients with advanced gastric cancer.METHODS From the gastric cancer patients admitted to our hospital from May 2019 to April 2023,84 patients were selected and randomly and equally assigned to the experimental or control group.The FLOT group received the FLOT chemotherapy regimen(composed of oxaliplatin+calcium folinate+fluorouracil+paclitaxel),while the SOX group received the SOX chemotherapy regimen(composed of oxaliplatin+tiga capsules).The clinical efficacy,tumor marker levels,adverse reactions,and survival rates of the two groups were compared 7 days after the end of the relevant treatments.RESULTS The target effective rate of the FLOT group was 54.76%,which was much higher than that of the SOX group(33.33%;P<0.05).After treatment,both the groups demonstrated lower levels of cancer antigen(CEA),carbohydrate antigen 199(CA199),and peptide tissue antigen(TPS).For several patients before treatment(P<0.05).Third and fourth grades.In terms of adverse reactions,the level of white blood cells in both the groups was lower.Moreover,the incidence of hand-foot skin reactions in these two study groups was lower(P<0.05),while those of peripheral neuritis,vomiting,diarrhea,and abnormal liver function were significant(P<0.05).No statistically significant difference was noted between the two groups(P<0.05).The 1-year survival rate was higher in the FLOT group(P<0.05).CONCLUSION The FLOT regimen was effective in reducing the serum CEA,CA199,and TPS levels as well as in improving the 1-year survival rate of patients with good tolerability,making it worthy of clinical promotion and application.

关键词： FLOT regimen SOX regimen Advanced gastric cancer first-line chemotherapy Tissue peptide-specific antigen

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FOLFOXIRI vs FOLFIRINOX as first-line chemotherapy in patients with advanced pancreatic cancer: A population-based cohort study

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World Journal of Gastrointestinal Oncology 2020年第3期12卷 332-346页

作者： Angélique Vienot Hortense Chevalier Clément Bolognini Elisabeta Gherga Elodie Klajer Aurélia Meurisse Marine Jary Stefano Kim Christelle d’Engremont Thierry Nguyen Fabien Calcagno Hamadi Almotlak Francine Fein Meher Nasri Syrine Abdeljaoued Anthony Turpin Christophe Borg Dewi Vernerey Department of Medical Oncology Besançon University HospitalBesançon F-25030France University Bourgogne Franche-Comté INSERMEFS BFCUMR1098Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et GéniqueBesançon F-25000France INSERM CIC-1431 Clinical Investigation Center in BiotherapyBesançon University HospitalBesançon F-25030France Department of Medical Oncology Lille University HospitalLille F-59000France Department of Medical Oncology Nord Franche-ComtéHospitalMontbéliard F-25020France Methodological and Quality of Life in Oncology Unit Besançon University HospitalBesançon F-25030France Department of Gastroenterology Besançon University HospitalBesançon F-25030France

BACKGROUND FOLFIRINOX regimen is the first-line reference chemotherapy(L1)in advanced pancreatic ductal adenocarcinoma(aPDAC).FOLFOXIRI,a schedule with a lower dose of irinotecan and no bolus 5-fluorouracil,has demonstrated efficacy and feasibility in colorectal cancer.AIM To investigate the potential clinical value of FOLFOXIRI in patients with aPDAC in routine clinical practice.METHODS Analyses were derived from all consecutive aPDAC patients treated in L1 between January 2011 and December 2017 in two French institutions,with either FOLFOXIRI(n=165)or FOLFIRINOX(n=124)regimens.FOLFOXIRI consisted of irinotecan(165 mg/m2),oxaliplatin(85 mg/m2),leucovorin(200 mg/m2)and 5-fluorouracil(3200 mg/m2 as a 48-h continuous infusion)every 2 wk.Ninety-six pairs of patients were selected through propensity score matching,and clinical outcomes of the two treatment regimens were compared.RESULTS Median overall survival was 11.1 mo in the FOLFOXIRI and 11.6 mo in the FOLFIRINOX cohorts,respectively.After propensity score matching,survival rates remained similar between the two regimens in terms of overall survival(hazard ratio=1.22;P=0.219)and progression-free survival(hazard ratio=1.27;P=0.120).The objective response rate was 37.1%in the FOLFOXIRI group vs 47.8%in the FOLFIRINOX group(P=0.187).Grade 3/4 toxicities occurred in 28.7%of patients in the FOLFOXIRI cohort vs 19.5%in the FOLFIRINOX cohort(P=0.079).FOLFOXIRI was associated with a higher incidence of grade 3/4 digestive adverse events.Hematopoietic growth factors were used after each chemotherapy cycle and the low hematological toxicity rates were below 5%with both regimens.CONCLUSION FOLFOXIRI is feasible in L1 in patients with aPDAC but does not confer any therapeutic benefit as compared with FOLFIRINOX.The low hematological toxicity rates strengthened the relevance of primary prophylaxis with hematopoietic growth factors.

关键词： Advanced pancreatic cancer first-line chemotherapy FOLFOXIRI FOLFIRINOX Propensity score Cohort study

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Efficacy and safety of gemcitabine plus S-1 vs. gemcitabine plus nab-paclitaxel in treatment-na?ve advanced pancreatic ductal adenocarcinoma

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Cancer Biology & Medicine 2023年第10期20卷 765-778页

作者： Zhou Zhu Hui Tang Jinrong Ying Yuejuan Cheng Xiang Wang Yingyi Wang Chunmei Bai Department of Medical Oncology Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China 4+4 Medical Doctor Program Chinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China

Objective:Gemcitabine plus nab-paclitaxel(GnP)is the standard first-line therapy for advanced pancreatic ductal adenocarcinoma(PDAC).S-1,an oral fluoropyrimidine derivative,as compared with gemcitabine,is non-inferior in terms of overall survival(OS)and is associated with lower hematologic toxicity.Accordingly,S-1 is a convenient oral alternative treatment for advanced PDAC.This study was aimed at comparing the efficacy and safety of gemcitabine plus S-1(GS)vs.GnP as first-line chemotherapy for advanced PDAC.Methods:Patients with advanced PDAC who received first-line GS or GnP at the Peking Union Medical College Hospital between March 2011 and November 2022 were evaluated.Results:A total of 300 patients were assessed,of whom 84 received GS and 216 received GnP.The chemotherapy completion rate was higher with GS than GnP(50.0%vs.30.3%,P=0.0028).The objective response rate(ORR)was slightly higher(14.3%vs.9.7%,P=0.35),and the median OS was significantly longer(17.9 months vs.13.3 months,P=0.0078),in the GS group than the GnP group.However,the median progression-free survival(PFS)did not significantly differ between groups.Leukopenia risk was significantly lower in the GS group than the GnP group(14.9%vs.28.1%,P=0.049).Conclusions:As first-line chemotherapy for advanced PDAC,the GS regimen led to a significantly longer OS than the GnP regimen.The PFS,ORR,and incidence of severe adverse events were comparable between the GS and GnP groups.

关键词： Advanced pancreatic cancer first-line chemotherapy gemcitabine S-1 nab-paclitaxel

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改良的EOF方案一线治疗晚期胃癌的Ⅱ期临床研究(英文)

改良的EOF方案一线治疗晚期胃癌的Ⅱ期临床研究(英文)

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浙江省第二十次肿瘤防治学术年会

作者：徐农 Department of Medical Oncology The First Affiliated HospitalSchool of MedicineZhejiang University79 Qingchun Rd．310003 HangzhouChina

Purpose: To evaluate the efficacy and safety of an epirubicin, oxaliplatin, and infusional 5-fluorouracil (modified EOF) combination in patients with advanced gastric cancer. Patients and Methods: Patients with previously untreated advanced measurable gastric cancer received epirubicin (50 mg /m2, day 1) , oxaliplatin (130 mg/m2 2-h infusion, day 1) and 5-fluorouracil (750 mg/m2 , 24-h infusion, day 1-3) every 3 weeks. The primary end point of this phase II study was the response rate according to RECIST criteria. Out of 48 patients, 46 were evaluable for efficacy and 48 for toxicity. A median of 5 cycles (range 1-6) was administered. Results: The overall best response rate was 47.8% (95% confidence interval [CI]:33-63%) including 2. 2% complete responses and 45. 6% partial responses. The median time to progression and median overall survival were 5.0 months (95% CI: 4.1-5.9 months) and 11.0 months (95% CI: 8.1-13.9 months), respectively. Grade 3/4 neutropenia and leucocytopenia were observed in 25% and 12. 5% of patients, respectively. Grade 3/4 non-haematological toxicities included nausea(6.3%), vomiting(14.6%), neurological toxicity(10. 4%) and mucositis(2.1%). Conclusion: The modified EOF regimen was effective and well tolerated as a front-line chemotherapy for patients with metastatic or advanced gastric cancer.

关键词： oxaliplatin 5-fluorouracil epirubicin first-line chemotherapy advanced gastric cancer

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