呋喹替尼治疗转移性结直肠癌的真实世界观察

Real world observation of fruquintinib in treatment of metastatic colorectal cancer

目的 探讨呋喹替尼治疗转移性结直肠癌(metastatic colorectal cancer,mCRC)的临床疗效和安全性。方法 收集本院2019年1月至2021年12月接受呋喹替尼三线或后线治疗的48例m CRC患者资料。分析其临床治疗、无进展生存期(progression-free survival,PFS)和不良反应发生情况。结果 48例mCRC患者接受呋喹替尼治疗2~17个周期,完全缓解(complete response,CR) 0例(0.0%),部分缓解(partial response,PR) 3例(6.2%),疾病稳定(stable disease,SD) 32例(66.7%),疾病进展(progressive disease,PD) 13例(27.1%),疾病控制率(disease control rate,DCR)为72.9%,客观缓解率(objective response rate,ORR)为6.2%,中位PFS为4.9个月。呋喹替尼单药治疗和联合治疗患者的中位PFS分别为4.7个月和6.2个月(P=0.445)。48例患者常见不良反应有高血压、手足皮肤反应、甲状腺功能异常、蛋白尿、乏力和肝功能异常。31.3%(15/48)的患者发生3~4级不良反应,主要是高血压和手足皮肤反应。结论 呋喹替尼在mCRC三线或后线治疗中有明确的临床获益,且耐受性良好,总体不良反应可控,与免疫治疗的联合值得进一步探索。

Objective To investigate the clinical efficacy and safety of fruquintinib in the treatment of metastatic colorectal cancer(mCRC).Methods The clinical data of 48 mCRC patients receiving fruquintinib as third-or later-treatment in our hospital from January 2019 to De-cember 2021 were collected.The treatment,progression-free survival(DFS)and incidence of adverse reactions were analyzed.Results The 48 mCRC patients received 2 to 17 cycles of fruquintinib treatment.Complete response(CR)was not observed(0.0%),partial response(PR)was observed in three cases(6.2%),stable disease(SD)in 32 cases(66.7%),and progressive disease(PD)in 13 cases(27.1%).The disease control rate(DCR)was 72.9%,and the objective response rate(ORR)was 6.2%.The median PFS was 4.9 months.The median PFS of patients with fruquintinib monotherapy and of those with fruquintinib combination therapy was 4.7 months and 6.2 months,respectively(P=0.445).Common adverse reactions in the 48 patients included hypertension,hand-foot-skin reactions,abnormal thyroid function,proteinuria,fatigue,and liver function abnormalities.31.3%(15/48)of patients experienced grade 3-4 adverse reactions,mainly presented as hypertension and hand-foot-skin reactions.Conclusions Fruquintinib demonstrates clear clinical benefits and good tolerability as third-or later-line treat-ment of mCRC.Overall adverse reactions are manageable,and further exploration of its combination with immunotherapy is warranted.