随着时间的推移，奥沙利铂化疗加靶向药物治疗转移性结直肠癌患者的时间生存改善：一项ARCAD数据库研究。

IF 7.1 1区医学 Q1 ONCOLOGY

European Journal of Cancer Pub Date : 2025-10-02 DOI:10.1016/j.ejca.2025.116034

Kazumasa Yamamoto , Hideaki Bando , Toshihiro Misumi , Tomomi Nishikawa , Masashi Wakabayashi , Kentaro Yamazaki , Yoshihiko Maehara , Eiji Oki , Leonard B. Saltz , Jean-Yves Douillard , Cornelis JA Punt , Miriam Koopman , Eric Van Cutsem , Carsten Bokemeyer , Alan P. Venook , Volker Heinemann , Chiara Cremolini , J. Randolph Hecht , Hans-Joachim Schmoll , Goro Nakayama , Takayuki Yoshino

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引用次数: 0

摘要

以奥沙利铂为基础的双重化疗联合分子靶向药物是转移性结直肠癌的标准一线治疗方案。然而，相关治疗结果的时间演变尚不清楚。我们利用Aide et Recherche en canc rologie Digestive （ARCAD）数据来评估与该方案相关的转移性结直肠癌临床结果的时间变化。方法：对2004年至2017年期间纳入ARCAD数据库的13项随机对照试验的5424名患者的数据进行个体患者数据荟萃分析。符合条件的患者接受基于奥沙利铂的化疗联合贝伐单抗或抗表皮生长因子受体抗体。对2004-2008年、2009-2013年和2014-2017年进行了研究。总体而言，使用Kaplan-Meier和Cox比例风险模型对关键预后因素进行校正，分析无进展生存率和进展后生存率。结果：中位总生存期随着时间的推移而提高，从21.4个月（2004-2008）到28.6个月（2009-2013）和29.7个月（2014-2017）。无进展和进展后生存率也观察到类似的趋势。多变量分析证实，治疗期是总生存率和无进展生存率的独立预后因素。亚组分析显示，左侧和RAS野生型肿瘤的总生存期有所改善，而右侧或RAS突变肿瘤的总生存期几乎没有改善。增加后续治疗的使用有助于延长进展后生存期。结论：我们证明了接受一线奥沙利铂化疗加分子靶向药物治疗的转移性结直肠癌患者的生存结局逐渐改善。研究结果强调了生物标志物驱动的治疗策略的重要性，以及后续治疗在优化临床结果中的作用。

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Chronological survival improvement over time with oxaliplatin-based chemotherapy plus targeted agents in metastatic colorectal cancer: An ARCAD database study

Introduction

The combination of oxaliplatin-based doublet chemotherapy and molecular targeted agents is the standard first-line treatment for metastatic colorectal cancer. However, the temporal evolution of associated treatment outcomes is unclear. We utilized Aide et Recherche en Cancérologie Digestive (ARCAD) data to evaluate the chronological changes in clinical outcomes associated with this regimen in metastatic colorectal cancer.

Methods

An individual patient data meta-analysis was performed using data from 5424 patients enrolled in 13 randomized controlled trials within the ARCAD database between 2004 and 2017. Eligible patients received oxaliplatin-based chemotherapy combined with bevacizumab or anti-epidermal growth factor receptor antibodies. Intervals of 2004–2008, 2009–2013, and 2014–2017 were examined. Overall, progression-free, and post-progression survivals were analyzed using Kaplan–Meier and Cox proportional hazards models adjusted for key prognostic factors.

Results

Median overall survival improved over time, from 21.4 months (2004–2008) to 28.6 months (2009–2013) and 29.7 months (2014–2017). Similar trends were observed for progression-free and post-progression survivals. Multivariable analysis confirmed the treatment period as an independent prognostic factor for overall and progression-free survivals. Subgroup analyses revealed improvements in overall survival for left-sided and RAS wild-type tumors, whereas minimal gains were found for right-sided or RAS-mutated tumors. Increased use of subsequent therapies contributed to prolonged post-progression survival.

Conclusions

We demonstrated progressive improvements in survival outcomes for patients with metastatic colorectal cancer receiving first-line oxaliplatin-based chemotherapy plus molecular targeted agents. The findings highlight the importance of biomarker-driven treatment strategies and the evolving role of subsequent therapies in optimizing clinical outcomes.

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来源期刊

European Journal of Cancer 医学-肿瘤学

CiteScore

11.50

自引率

4.80%

发文量

953

审稿时长

23 days

期刊介绍： The European Journal of Cancer (EJC) serves as a comprehensive platform integrating preclinical, digital, translational, and clinical research across the spectrum of cancer. From epidemiology, carcinogenesis, and biology to groundbreaking innovations in cancer treatment and patient care, the journal covers a wide array of topics. We publish original research, reviews, previews, editorial comments, and correspondence, fostering dialogue and advancement in the fight against cancer. Join us in our mission to drive progress and improve outcomes in cancer research and patient care.