RS联合贝伐单抗与RS联合福罗替尼作为难治性转移性结直肠癌患者三线疗法的疗效与安全性：一项真实世界倾向评分匹配研究。

IF 3.6 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Journal of Evidence‐Based Medicine Pub Date : 2024-09-26 DOI:10.1111/jebm.12652

Yuwen Zhou, Qian Xu, Jialing Wang, Wei-Bing Leng, Peng Cao, Ye Chen, De-Yun Luo, Meng Qiu, Jiyan Liu

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引用次数: 0

摘要

研究背景本研究旨在比较雷替曲塞、S-1（RS）和fruquintinib联合疗法与RS和贝伐珠单抗联合疗法在难治性转移性结直肠癌（mCRC）患者中的有效性和安全性：这项回顾性队列研究纳入了2019年5月至2023年4月期间接受RS加fruquintinib或瑞戈非尼作为三线疗法的mCRC患者。采用倾向评分匹配（PSM）分析平衡所有患者的基线特征。对两种方案的总生存期（OS）、无进展生存期（PFS）、肿瘤反应和安全性进行了评估：在153名入组患者中，123名患者接受了RS加贝伐珠单抗治疗，30名患者接受了RS加福昆替尼治疗。PSM 后，对 30 对患者进行了分析。在 PSM 前（5.0 个月 vs. 4.3 个月，p = 0.008）和 PSM 后（5.0 个月 vs. 4.4 个月，p = 0.012），接受 RS 加夫鲁喹替尼治疗的患者的 PFS 比接受 RS 加贝伐单抗治疗的患者更长。在 PSM 前和 PSM 后，RS 加夫鲁喹替尼组的 OS 也更长，但 PSM 后两组间无统计学差异。在PSM前，RS加弗仑替尼组的客观反应率和疾病控制率均高于RS加贝伐单抗组，而在PSM后，两组之间的数值差异缩小。两组患者的不良反应（AEs）耐受性良好：结论：在难治性mCRC患者中，RS联合fruquintinib的OS和PFS均优于RS联合贝伐珠单抗，且不良反应（AEs）可控。

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Efficacy and safety of RS plus bevacizumab versus RS plus fruquintinib as the third-line therapy in patients with refractory metastatic colorectal cancer: A real-world propensity score matching study

Background

This study aims to compare the effectiveness and safety of the combination of raltitrexed, S-1 (RS), and fruquintinib with the combination of RS and bevacizumab in patients with refractory metastatic colorectal cancer (mCRC).

Methods

This retrospective cohort included mCRC patients who received the RS plus fruquintinib or regorafenib as the third-line therapy from May 2019 to April 2023. A propensity score matching (PSM) analysis was used to balance the baseline characteristics of all patients. Overall survival (OS), progression-free survival (PFS), tumor response, and safety of the two regimens were evaluated.

Results

Of the 153 patients enrolled, 123 patients received the RS plus bevacizumab and 30 patients received the RS plus fruquintinib. After PSM, 30 pairs were analyzed. Patients treated with RS plus fruquintinib had a longer PFS than those treated with RS plus bevacizumab before PSM (5.0 months vs. 4.3 months, p = 0.008) and after PSM (5.0 months vs. 4.4 months, p = 0.012). A longer OS was also observed in RS plus fruquintinib group before PSM and after PSM, but there was no statistic difference between two groups after PSM. Both objective response rate and disease control rate were higher in the RS plus fruquintinib cohort than those in the RS plus bevacizumab cohort before PSM, and the difference in values between the two groups reduced after PSM. The adverse effects (AEs) of both groups were well tolerated.

Conclusion

In patients with refractory mCRC, RS plus fruquintinib demonstrated a superior OS, PFS than RS plus bevacizumab and had manageable AEs.

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来源期刊

Journal of Evidence‐Based Medicine MEDICINE, GENERAL & INTERNAL-

CiteScore

11.20

自引率

1.40%

发文量

期刊介绍： The Journal of Evidence-Based Medicine (EMB) is an esteemed international healthcare and medical decision-making journal, dedicated to publishing groundbreaking research outcomes in evidence-based decision-making, research, practice, and education. Serving as the official English-language journal of the Cochrane China Centre and West China Hospital of Sichuan University, we eagerly welcome editorials, commentaries, and systematic reviews encompassing various topics such as clinical trials, policy, drug and patient safety, education, and knowledge translation.