西妥昔单抗在贝伐单抗后应用，是最好的顺序吗？（2011年，消化道和肝病杂志）
化疗联合爱必妥或贝伐单抗可以提高转移性结直肠癌的总生存期。然而，当贝伐单抗治疗失败后应用爱必妥是否有效仍不为所知。58例连续性诊断为进展期结直肠的患者，在伊立替康联合爱必妥治疗失败的病人纳入研究。应用多变量cox回归模型分析先前应用含贝伐单抗方案的生存期。结果发现：13例（22.4%）先前应用过抗血管药物，其中无一例对爱必妥有反应，这个亚组相对于未应用过抗血管药物组表现出显著降低的疾病特异生存期（9.1个月VS4.9个月，P=0.026）.而这种差别在经过年龄，性别，PS评分，K-RAS状态调整后，应用多变量分析后仍有显著差别。因此得出如下结论：先前应用抗血管药物可能降低爱必妥的效果。
Cetuximab after bevacizumab in metastatic colorectal cancer: Is it the best sequence? ☆
Emmanuelle Norgueta, 1, , , Laetitia Dahana, 1, Jean Gaudartc, Mohamed Gasmib, L’houcine Ouafikd, Jean-François Seitza
a Assistance Publique – Hôpitaux de Marseille, Service d’oncologie digestive Hôpital Timone, Université de la Méditerranée, Marseille, France
b Assistance Publique – Hôpitaux de Marseille, Service d’hépatogastroentérologie Hôpital Nord, Université de la Méditerranée, Marseille, France
c Aix Marseille Université, Faculté de Médecine, LERTIM, Equipe biostatistique, Marseille, France
d Faculté de médecine Nord, laboratoire de transfert d’oncologie biologique, Université de la Méditerranée, Marseille, France
2011年
Abstract
Background
Chemotherapy combinations and addition of cetuximab or bevacizumab to chemotherapy have been shown to improve overall survival of metastatic colorectal cancer (CRC) patients. However, the efficacy of cetuximab when administered after bevacizumab failure is still unknown. Methods Fifty-eight consecutive patients diagnosed with advanced colorectal cancer between treated with cetuximab following irinotecan failure were included in our analysis. A multivariate Cox model analysis was performed to estimate the effect of previous bevacizumab regimen on survival.ResultsThirteen (22.4%) were pre-treated with anti-VEGF agents. None of them responded to cetuximab, and this subgroup presented a significantly decreased disease-specific survival as compared to treatment-naïve patients (9.1 months vs. 4.9 months; p = 0.026). This difference remained statistically significant in a multivariate Cox model after adjusting for age, sex, performance status (PS), and K-RAS status (RR = 2.2; 95% CI: 1.1–4.5, p = 0.03).ConclusionThese study results suggest that a previous anti-VEGF therapy decrease cetuximab efficiency.Keywords
Bevacizumab; Cetuximab; Colorectal cancer
