The clinical efficacy of FOLFOX combined with bevacizumab/cetuximab in the first line treatment of advanced colorectal cancer with wild-type KRAS / 肿瘤

ABSTRACT

Objective: To compare the efficacy and main side effects of bevacizumab vs cetuximab plus FOLFOX regimen as the first-line treatment in advanced colorectal cancer patients with wild-type KRAS gene, and to evaluate the survival. Methods: Between January 2008 and February 2014, 72 patients were pathologically diagnosed of stage IV colorectal cancer with wild-type KRAS gene in People's Liberation Army General Hospital. Of 72 patients, 28 received FOLFOX regimen, 17 received bevacizumab combined with FOLFOX regimen, and 27 received cetuximab combined with FOLFOX regimen. After three cycles of chemotherapy, the short-term response was evaluated; the side effects were observed. All the patients were followed-up, and the progression-free survival (PFS) was calculated. Results: In FOLFOX regimen group, the objective response rate (ORR), disease control rate (DCR) and median PFS were 14.3%, 75.0% and 8.0 months, respectively; in bevacizumab combined with FOLFOX regimen group, these outcome measurements were 64.7%, 94.1% and 10.0 months, respectively; and in cetuximab combined with FOLFOX regimen group, these outcome measurements were 59.3%, 92.6% and 9.2 months, respectively. The ORR of FOLFOX regimen group was significantly lower than those in bevacizumab/cetuximab combined with FOLFOX regimen groups (χ2 = 12.101, P= 0.000 5; χ2 = 12.014, P = 0.000 5). There were no significant differences in DCR and median PFS among the three groups (P > 0.05). Conclusion: Bevacizumab/cetuximab combined with FOLFOX regimen can improve the ORR, DCR and median PFS in advanced colorectal cancer patients with wild-type KRAS. These two combined regimens have a quite similar efficacy, less adverse reactions and good tolerance.