Bevacizumab in the pre-operative treatment of locally advanced rectal cancer: A systematic review

Despite advances in the management of patients with locally advanced, non-metastatic rectal adenocarcinoma (LARC), prognosis remains largely unsatisfactory due to a high rate of distant relapse. In fact, currently available neoadjuvant protocols, represented by fluoropyrimidine-based chemo-radiotherapy (CT-RT) or short-course RT, together with improved surgical techniques, have largely reduced the risk of local relapse, with limited impact on distant recurrence. Available results of phase III trials with additional cytotoxic agents combined with standard CT-RT are disappointing, as no significant reduction in the risk of recurrence has been demonstrated. In order to improve the control of micrometastatic disease, integrating targeted agents into neoadjuvant treatment protocols thus offers a rational approach. In particular, the antiangiogenic agent bevacizumab has demonstrated synergistic activity with both CT and RT in pre-clinical and clinical models, and thus may represent a suitable companion in the neoadjuvant treatment of LARC. Preliminary results of phase I-II clinical studies are promising and suggest potential clinical parameters and molecular predictive biomarkers useful for patient selection: treatment personalization is indeed the key in order to maximize the benefit while reducing the risk of more complex neoadjuvant treatment schedules.

Outcomes of palliative local treatment in metastatic colorectal cancer patients receiving chemotherapy plus bevacizumab

Objective The aim of this study was to assess the value of palliative local treatment of incurable metastatic lesions in colorectal cancer(CRC) patients receiving chemotherapy plus bevacizumab.Methods Data of 105 patients with histologically confirmed synchronous or metachronous metastatic CRC who received bevacizumab treatment from January 1, 2011 to January 31, 2017 were retrospectively reviewed. Sixteen(15%) patients who were treated with bevacizumab for less than 4 cycles were excluded, and finally, 89(85%) patients were enrolled. Among them, 33(37%) patients who received palliative local treatment were categorized into the palliative local treatment group, and the remaining 56(63%) patients were categorized into the chemotherapy plus bevacizumab group. The primary endpoint was overall survival(OS), which was calculated using Kaplan-Meier survival analyses. Factors possibly influencing survival were evaluated by univariate and multivariate analyses. Adverse events(AEs) were graded according to Common Terminology Criteria for Adverse Events, version 4.0. Grades 1–2 and 3–4 AEs of the two groups were compared and analyzed using the Fisher's exact test and χ~2 analysis.Results The median follow-up period was 20.4 months, ranging from 1 to 60 months. The median OS in the palliative local treatment group was 36.3 months(95% CI, 33.5–39.2), and that in the chemotherapy plus bevacizumab group was 20.5 months(95% CI, 17.6–23.4). Both the univariate(HR 0.13, 95% CI, 0.05–0.30, P < 0.001) and multivariate(HR 0.16, 95% CI, 0.07–0.39, P < 0.001) analyses showed that the addition of palliative local treatment could prolong survival compared with chemotherapy plus bevacizumab alone. There were no significant differences in the rates of common chemotherapy-or bevacizumab-related AEs between the two groups.Conclusion These findings suggest palliative local treatment is an effective and safe method for treating patients with incurable metastatic CRC receiving chemotherapy plus bevacizumab.

Induction of vascular endothelial growth factor receptor expression in human umbilical vein endothelial cells after repeated bevacizumab treatment in vitro

AIM： To investigate the mechanism underlying the loss of responsiveness to anti-vascular endothelial growth factor（VEGF） treatment after repeated injections for choroidal neovascularization, VEGF and VEGF receptor（VEGFR） expressions were evaluated following repeated bevacizumab treatments in hypoxic human umbilical vein endothelial cells（HUVECs） in vitro.METHODS： HUVECs were incubated under hypoxic conditions in two media of different bevacizumab concentrations（1.0 or 2.5 mg/m L） for 17 h, and then in a new medium without bevacizumab for 7h. This procedure was repeated twice more. A culture with an identical volume of excipients served as the control. Cytotoxicity and cell proliferation were assessed using 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide and Ki-67 assays, respectively. Levels of VEGF and VEGFR were assessed using enzyme-linked immunosorbent assay and Western blot respectively.RESULTS： Cytotoxic effects were not reported for either bevacizumab concentration. Cell proliferation was not reduced after anti-VEGF treatments. VEGF level after single treatment was significantly higher than that of the control and after repeated treatments. Phosphorylated VEGFR-2 expression increased significantly after singleand repeated bevacizumab treatments compared with the control. The 1.0 mg/m L bevacizumab induced significantly higher expressions of VEGFR-2 than the 2.5 mg/m L in single and repeated treatment groups.CONCLUSION： Bevacizumab treatment of HUVECs elevated VEGFR expression in both single and repeated treatments, indicating a mechanism for the reduced efficacy of anti-VEGF therapy in ocular neovascular disorders.

Comparison of structural outcome between intravitreal bevacizumab and laser treatment for type 1 retinopathy of prematurity after long-term follow-up

Background:To compare the structural outcome of intravitreal bevacizumab(IVB)and laser treatment for type 1 retinopathy of prematurity(ROP).Methods:This is a retrospective comparative study.From December 2002 to April 2009,patients with type 1ROP according to criteria of Early Treatment of Retinopathy of Prematurity(ETROP)study were treated by peripheral retinal diode laser photocoagulation in nearly confluent pattern.From May 2009 to January 2015,we performed IVB for patients with type 1 ROP.The patients were closely followed until disappearance of retinal neovascularization in the laser group and regression of avascular zone in the bevacizumab group.The demographical data,postmenstrual age(PMA)for treatment,and fundus findings were recorded by chart review.The difference between laser and bevacizumab groups was compared by Student t-test and Fisher exact test.Results:We collected 43 patients(86 eyes)with type 1 ROP,including 30 male and 13 female infants.Their mean gestation age and birth body weight(BBW)were 27.5 weeks and 1,034 gm.Zone I and zone II disease were found in 8 and 35 patients.The mean PMA for treatment was 37.3 weeks.The mean follow-up period was54.4 months.Laser treatment was administered in 26 patients,and bevacizumab injection for 17 infants.Single session of laser was performed in all patients of laser group without recurrence of retinal neovascularization.Complete regression of ROP was found in 15 infants of bevacizumab group following the first IVB.Four eyes in two patients(2/17,11.7%)had recurrence of ROP and received additional injections and adjuvant laser treatment.There was no unfavorable anatomical results such as retinal detachment or macular ectopia or complications such as cataract or endophthalmitis in either bevacizumab or laser management.Conclusions:Laser therapy and IVB were both effective treatments for type 1 ROP to cause favorable anatomical outcomes.Single session of laser ablation in nearly confluent pattern was sufficient for complete regression of ROP in laser group.Single IVB was appropriate for managing most of cases with ROP in bevacizumab group,but a small proportion(nearly one tenth)of them had recurrent episodes requiring adjuvant therapies.

Bevacizumab(Avastin)对眼科疾病的治疗作用

贝代单抗(bevacizumab)是近几年出现的重组单克隆抗体,通过抑制血管内皮生长因子(VEGF)达到抑制新生血管生成的作用。在眼科中,对于角膜、虹膜、脉络膜、视网膜的新生血管及年龄相关性黄斑变性、黄斑水肿等疾病的治疗具有很可观的应用前景。

Bevacizumab(Avastin)抑制角膜新生血管的应用新进展

诱发角膜新生血管的因素涉及各种生长因子。研究表明:在角膜新生血管中广泛存在的血管内皮生长因子(vascular endothelial growth factor,VEGF)起着主要作用。一种可行的治疗角膜新生血管策略是:通过特异性的中和抗VEGF抗体竞争性的结合VEGF,从而抑制VEGF活性。近年来,利用抗VEGF治疗策略,抑制脉络膜新生血管获得了很好的效果。靶向VEGF治疗药物的疗效和安全性已经证明。因此我们设想,局部应用新的抗VEGF药物,如贝伐单抗、兰尼单抗等可以有效地抑制角膜新生血管,恢复角膜透明和视力。

First-line pemetrexed-platinum doublet chemotherapy with or without bevacizumab in non-squamous non-small cell lung cancer: A real-world propensity score-matched study in China

Objective: To evaluate the efficacy and safety profile of first-line bevacizumab(Bev)-containing pemetrexedplatinum chemotherapy in a real-world Chinese cohort with advanced non-squamous non-small cell lung cancer(NS-NSCLC).Methods: A total of 415 eligible patients with NS-NSCLC who received first-line pemetrexed-platinum chemotherapy at National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College between February 2010 and September 2017 were reviewed retrospectively: 309 Bev(-) and 106 Bev(+) cases. Bev was administered at 7.5 mg/kg every 3 weeks in the Bev(+) group. To reduce the risk of a selection bias, a propensity score-matching(PSM) was conducted and 105 pairs of Bev(-) and Bev(+) cases were identified.Results: The median duration of follow-up was 15.8 months. The median progression-free survival(PFS) was prolonged significantly in the Bev(+) group than in the Bev(-) group in overall(9.8 vs. 7.8 months, P=0.006) and PSM pairs(9.8 vs. 6.6 months, P<0.001). Moreover, patients receiving maintenance therapy with pemetrexed plus Bev had longer PFS than those interrupted after induction chemotherapy, or those receiving mono-maintenance with pemetrexed(12.3 vs. 4.8 vs. 8.6 months;P<0.001). Multivariate analyses revealed Bev to be one of the favorable prognostic factors for PFS, along with the predictor of maintenance therapy.Conclusions: First-line induction and maintenance therapy with Bev(7.5 mg/kg every 3 weeks) combined with pemetrexed-platinum chemotherapy was efficacious and superior to non-Bev chemotherapy in Chinese patients with advanced NS-NSCLC.

Growth factor receptors and related signalling pathways as targets for novel treatment strategies of hepatocellular cancer

Growth factors and their corresponding receptors are commonly overexpressed and/or dysregulated in many cancers including hepatocellular cancer （HCC）. Clinical trials indicate that growth factor receptors and their related signalling pathways play important roles in HCC cancer etiology and progression, thus providing rational targets for innovative cancer therapies. A number of strategies including monoclonal antibodies, tyrosine kinase inhibitors （＂small molecule inhibitors＂） and antisense oligonucleotides have already been evaluated for their potency to inhibit the activity and downstream signalling cascades of these receptors in HCC. First clinical trials have also shown that multi-kinase inhibition is an effective novel treatment strategy in HCC. In this respect sorafenib, an inhibitor of Raf-, VEGF- and PDGF-signalling, is the first multi-kinase inhibitor that has been approved by the FDA for the treatment of advanced HCC. Moreover, the serine-threonine kinase of mammalian target of rapamycin （mTOR） upon which the signalling of several growth factor receptors converge plays a central role in cancer cell proliferation, roTOR inhibition of HCC is currently also being studied in preclinical trials. As HCCs represent hypervascularized neoplasms, inhibition of tumour vessel formation via interfering with the VEGF/VEGFR system is another promising approach in HCC treatment. This review will summarize the current status of the various growth factor receptor-based treatment strategies and in view of the multitude of novel targeted approaches, the rationale for combination therapies for advanced HCC treatment will also be taken into account.

Efficacy and safety of bevacizumab plus chemotherapy in Chinese patients with metastatic colorectal cancer:a randomized phase Ⅲ ARTIST trial

The efficacy and safety of bevacizumab with modified irinotecan,leucovorin bolus,and 5-fluorouracil intravenous infusion(mIFL) in the first-line treatment of metastatic colorectal cancer(mCRC) has not been well evaluated in randomized clinical trials in Chinese patients.We conducted a phrase Ⅲ trial in which patients with previously untreated mCRC were randomized 2:1 to the mIFL [irinotecan(125 mg/m2),leucovorin(20 mg/m2) bolus,and 5-fluorouracil intravenous infusion(500 mg/m2) weekly for four weeks every six weeks] plus bevacizumab(5 mg/kg every two weeks) group and the mIFL group,respectively.Co-primary objectives were progression-free survival(PFS) and 6-month PFS rate.In total,214 patients were enrolled.Our results showed that addition of bevacizumab to mIFL significantly improved median PFS(4.2 months in the mIFL group vs.8.3 months in the bevacizumab plus mIFL group,P < 0.001),6-month PFS rate(25.0% vs.62.6%,P < 0.001),median overall survival(13.4 months vs.18.7 months,P = 0.014),and response rate(17% vs.35%,P = 0.013).Grades 3 and 4 adverse events included diarrhea(21% in the mIFL group and 26% in the bevacizumab plus mIFL group) and neutropenia(19% in the mIFL group and 33% in the bevacizumab plus mIFL group).No wound-healing complications or congestive heart failure occurred.Our results suggested that bevacizumab plus mIFL is effective and well tolerated as first-line treatment for Chinese patients with mCRC.Clinical benefit and safety profiles were consistent with those observed in pivotal phase Ⅲ trials with mainly Caucasian patients.

6-weekly bevacizumab versus 4-weekly ranibizumab for neovascular age-related macular degeneration:a 2-year outcome

AIM： To compare visual acuity and central macular thickness（CMT） changes in neovascular age-related macular degeneration patients treated with either 6weekly bevacizumab regimen or 4 weekly ranibizumab on an as required basis.·METHODS： Patients made an informed choice between bevacizumab 1.25 mg or ranibizumab 0.5 mg. The selected treatment was administered in the first 3 visits.Bevacizumab patients were followed-up 6 weekly and ranibizumab 4 weekly. Retreatment criteria was based on the reduction of 〉5 letters in the best-corrected visual acuity（BCVA）, the presence of retinal fluid on optical coherence tomography（OCT） or new retinal haemorrhage.·RESULTS： Visual acuity at 2y bevacizumab patients gained 7. 0 letters and ranibizumab 9. 2（ P = 0. 31, 95 %CI-6.4 to 2.0）. At 2y 86% of bevacizumab and 94%ranibizumab patients had not lost 15 letters or more（P =0.13）. Mean CMT decreased at 2y bevacizumab by 146 μm,ranibizumab 160 μm（P =0.72）. Mean number of injections was at 2y bevacizumzb 11.9, ranibizumab 10.3（P =0.023）.· CONCLUSION： Bevacizumab 6 weekly on an as required basis was not demonstrably non-inferior to ranibizumab 4 weekly pro re nata（prn） in terms of BCVA and change in CMT. In the bevacizumab group, one more injection was required in the second year compared to the ranibizumab group.

Anti-vascular endothelial growth factor treatment for retinopathy of prematurity

Retinopathy of prematurity(ROP)is a proliferative disorder of the developing retina in premature and low birth weight infants.Recently,the role of vascular endothelial growth factor(VEGF)in the pathophysiology of ROP has been well studied and anti-VEGF drugs have been used in phase 2 to treat ROP patients in many ways.At first,ophthalmologists began to give intravitreal bevacizumab(IVB)or ranibizumab off-label to treat ROP as a salvage treatment after failure in laser photocoagulation or in combination with laser as an adjuvant treatment for patients had media opacity or rigid pupil.Now anti-VEGF drugs are also used as monotherapy in type I ROP or perioperative use in stage 4/5 ROP.Questions remain regarding long-term safety,dose,timing,visual outcomes and long-term effects,including systemically.

Molecular pathogenesis of glioblastoma multiforme: Nuances, obstacles, and implications for treatment

Glioblastoma multiforme(GBM), the literal apogee on the hierarchy of malignant brain tumors, remains one of the greatest therapeutic challenges in oncology andmedicine. Historically this may be contextualized in the fact that the medical and scientific communities have had a very elementary understanding of its intricate and complex pathophysiology. The last 10-15 years have yielded a number of studies that have elucidated much of the molecular and genetic complexities of GBM that underlie its pathogenesis. Excitingly, some of these discovered genetic mutations and molecular profiles in GBM have demonstrated value in prognostication and utility in predicting response to treatment. Despite this, however, treatment options for patients have remained somewhat limited. These treatment options are expected to expand with the availability of new data and with the transition of novel treatment modalities from animal to human studies. This paper will have a threefold objective: provide an overview of the traditional paradigm in understanding and treating GBM, describe recent discoveries in the molecular pathogenesis of GBM against this historical backdrop, and acquaint the reader with new treatment modalities that hold significant therapeutic potential for patients.

玻璃体腔注射Bevacizumab联合PDT治疗CSC

目的:研究玻璃体腔注射bevacizumab联合PDT治疗中心性浆液性视网膜脉络膜病变(central serous choroiretinopathy,CSC)患者的临床疗效。方法:选取2012-02/2015-04于我院就诊的CSC患者82例82眼作为研究对象,所有患者均经OCT、FFA确诊,且均为单眼患病。按治疗方法不同将所有患者分为对照组35例35眼和研究组47例47眼。其中对照组患者采用光动力(PDT)治疗,研究组患者采用PDT联合玻璃体腔内注射bevacizumab治疗。对比两组患者治疗次数、浆液性色素上皮脱离(PED)平伏率和黄斑视网膜下液、黄斑中心区直径的总体积、黄斑中心区直径6mm的平均厚度和黄斑中心区1mm范围的厚度等OCT指标,以及治疗前后不同时间最佳矫正视力和临床疗效。结果:对照组患者中32眼治疗1次,3眼治疗2次,平均治疗次数为1.25±0.20次;研究组中9眼治疗3次,10眼治疗2次,28眼治疗1次,平均治疗次数1.48±0.22次。两组患者治疗次数对比差异无统计学意义(t=1.209,P>0.05)。对照组患者PED平伏13眼(37%),黄斑视网膜神经上皮下浆液吸收22眼(63%)。研究组患者PED平伏30眼(64%),黄斑视网膜神经上皮下浆液吸收17眼(36%)。两组患者治疗后PED平伏率和黄斑视网膜神经上皮下浆液吸收率对比均差异均有统计学意义(P<0.05)。两组患者治疗前黄斑中心区直径的总体积、黄斑中心区直径6mm的平均厚度和黄斑中心区1mm范围的厚度等OCT指标对比差异无统计学意义(P>0.05),而治疗后研究组患者在这些OCT指标上均明显低于对照组,且差异均有统计学意义(P<0.05)。两组患者治疗后在这些OCT指标均明显低于各组治疗前,且均有统计学意义(P<0.05)。两组患者治疗前和治疗后1mo最佳矫正视力对比差异无统计学意义(P>0.05),治疗后3、6mo时研究组患者最佳矫正视力(LogM AR)明显低于对照组,且差异均有统计学意义(P<0.05)。对照组患者中无效6眼,好转15眼,显效8眼,治愈6眼,总有效率为83%;研究组患者中无效3眼,好转8眼,显效20眼,治愈16眼,总有效率为94%,两组患者总有效率对比差异有统计学意义(P<0.05)。结论:在慢性CSC合并PED患者治疗中玻璃体注射抗VEGF单克隆抗体bevacizumab联合低剂量PDT在平伏PED,促进黄斑视网膜下浆液吸收,降低黄斑视网膜厚度,改善视力方面优于单一PDT治疗患者。

贝伐珠单抗联合卡培他滨维持对晚期结肠癌患者预后的影响

目的:探究贝伐珠单抗联合卡培他滨维持对晚期结肠癌患者预后的影响。方法:收集2017年1月至2019年1月期间我院101例晚期结肠癌患者的病例资料,所有患者均接受5-氟尿嘧啶及卡培他滨为基础的贝伐珠单抗联合mFOLFOX6或XELOX化疗一线化疗方案,其中42例患者一线化疗后接受卡培他滨单药维持治疗,纳入对照组,59例患者接受贝伐珠单抗联合卡培他滨维持治疗,纳入观察组,两组治疗均直至病情进展或毒副反应无法耐受。比较两组患者维持治疗时间和疾病控制时间,治疗前后Karnofsky功能状态评分(KPS)、美国东部肿瘤协作组体力状态评分(ZPS),血清肿瘤标志物水平,毒副反应以及远期预后情况。结果:观察组维持治疗时间、疾病控制时间均大于对照组(P<0.05);两组KPS均较治疗前升高,ZPS均较治疗前降低,观察组变化幅度均大于对照组(P<0.05);两组血清癌胚抗原(CEA)、唾液酸化盐藻戊糖(CA199)、胃癌抗原(CA724)水平均较治疗前降低,观察组变化幅度均大于对照组(P<0.05);两组毒副反应发生情况差异无统计学意义(P>0.05);观察组总生存率高于对照组(P<0.05)。结论:晚期结肠癌一线治疗后贝伐珠单抗联合卡培他滨维持治疗安全有效,可延长生存时间,同时不良反应轻微。

Treatment options for the wet form of age-related macular degeneration--a perspective

Treatment of the wet form of age-related macular degeneration(wet AMD) has been revolutionized a decade ago with the introduction of vascular endothelial growth factor(VEGF) blockers that reduce neovascularization and macular edema. Two approved drugs are marketed for the treatment of wet AMD—ranibizumab and aflibercept, but there is a third drug, bevacizumab, which is widely used offlabel; a cancer drug that also blocks VEGF but was never tested in pivotal trials and never approved for ophthalmic indications including wet AMD. Similarity of bevacizumab to ranibizumab led to off-label use and even to government-sponsored studies comparison the approved ranibizumab head-to-head to the offlabel cancer drug bevacizumab in wet AMD, like the Comparison of Age-related Macular Degeneration Treatments Trials(CATT) study, discussed in this perspective paper. Recent publication of 5-year follow-up from the initial 2-year CATT study provided the occasion to discuss the similarities and differences between these two drugs and the lessons learned from the last decade of anti-VEGF therapy for wet AMD. Clinical efficacy is comparable, with an advantage for ranibizumab. Likewise, safety finding favor ranibizumab over bevacizumab in some aspects. The latest addition of approved anti-VEGF drugs for wet AMD, aflibercept, may provide even more benefit to patients. In this perspective we discuss results of CATT and other longterm follow-up and comparative studies. While all demonstrate clinical benefit of anti-VEGF, all reveal that most patients' loose visual acuity(VA) in real-life situations over 5–7 years. This loss is based on—what we believe—significant under-treatment of wet AMD patients, due to economic or practical limitations and overestimation of perceived risks as geographic atrophy. We compare own data that showed more intensive treatment(more than twice the CATT-follow-up injections) with ranibizumab or aflibercept can maintain a sustained gain in VA in wet AMD patients after 6 years. We encourage retina specialists to treat wet AMD patients more aggressively and frequently in order to provide the maximum benefit for their patients.

替尼泊苷动脉化疗联合贝伐珠单抗在复发高级别脑胶质瘤的临床回顾性研究

目的:探索替尼泊苷超选动脉化疗联合贝伐珠单抗在复发高级别脑胶质瘤治疗的临床疗效和安全性。方法:79例复发高级别脑胶质瘤患者按治疗方法的不同,分为试验组37例(替尼泊苷动脉化疗联合贝伐珠单抗治疗)和对照组42例(贝伐珠单抗单药治疗),比较两组患者脑胶质瘤维持治疗后的客观缓解率、疾病控制率及不良反应率,评估O~6-甲基鸟嘌呤-DNA甲基转移酶基因启动子甲基化状态对两组患者疾病控制率的影响。结果:试验组和对照组的客观缓解率分别为43.2%和21.4%(P=0.038),疾病控制率分别为78.4%和54.8%(P=0.027)。试验组在轻度消化道反应(P=0.044)、头痛(P=0.044)及白细胞减少(P=0.026)的不良反应发生率高于对照组。试验组年龄小于60岁人群的疾病控制率较对照组明显增加(P<0.05)。结论:在高级别脑胶质瘤维持治疗中,替尼泊苷超选动脉化疗联合贝伐珠单抗的疗效优于贝伐珠单抗单药治疗,值得临床进一步推广。

伊立替康+奥沙利铂+卡培他滨联合贝伐单抗双周方案一线治疗晚期转移性大肠癌的疗效和安全性

目的观察伊立替康+奥沙利铂+卡培他滨联合贝伐单抗双周方案一线治疗晚期转移性大肠癌的疗效和安全性。方法回顾性纳入2023年2月至2024年2月我院晚期转移性结直肠癌患者31例,均采用一线治疗:伊立替康160 mg/m^(2)第1天+奥沙利铂85 mg/m2第2天+卡培他滨1000 mg/m^(2)第1~8天(每日2次)+贝伐单抗5 mg/kg第1天(每2周用药1次)。分析该方案在不同基因突变、不同肿瘤位置的人群中的疗效和安全性。结果4例潜在可切除转移性大肠癌患者经三药化疗联合贝伐单抗治疗后成功切除原发灶和转移灶,其中2例存活且无复发转移,2例因复发转移而死亡。27例初始不可切除大肠癌患者接受三药化疗和贝伐单抗治疗后,虽无人手术,但总体缓解率达70.4%,中位持续缓解时间12.2个月,中位无进展生存期(PFS)13个月,中位总生存期(OS)33.5个月。在PFS方面,三药化疗联合贝伐单抗对基因突变大肠癌患者更有优势,但OS上两组相似;对于左半大肠癌患者,该治疗方案在基因突变人群中优势更显著,但OS无统计学差异;右半大肠癌患者数据不足以进行基因型疗效对比。左半大肠癌基因突变患者的PFS较右半更有优势,但两者在OS上无统计学差异。东部肿瘤协作组(ECOG)评分为0分和1分的患者在接受三药化疗联合贝伐单抗治疗后,在PFS和OS上均无统计学差异。共纳入31例,该方案≥3级不良反应发生率为45.2%,因不良反应下调任何一种药物剂量的发生率为45.2%(最常见原因是骨髓抑制包括白细胞、中性粒细胞和血小板减少),有35.5%患者因不良反应中断/推迟治疗,12.9%因不良反应完全终止该方案;另外,对于初始明确不可切除的患者,虽无差异,但左半人群在数值上仍然有所提高。结论伊立替康+奥沙利铂+卡培他滨+贝伐单抗的双周化疗方案在RAS突变的晚期转移性大肠癌的一线治疗中具有一定潜力,能有效降低不良反应,延长生存期,且临床疗效较为显著,但在未来仍需进一步扩大样本量以明确该方案的疗效和安全性。

贝伐珠单抗联合化疗方案治疗非小细胞肺癌的临床研究

目的 探讨贝伐珠单抗联合化疗方案治疗非小细胞肺癌(NSCLC)患者的临床效果。方法 选取2018年6月至2022年6月我院收治的66例NSCLC患者,随机分为常规组和联合组各33例。常规组采用化疗方案治疗,联合组采用贝伐珠单抗联合化疗方案治疗,比较两组患者的治疗效果、血清指标水平变化及生存质量。结果 联合组治疗总有效率为72.73%,高于常规组的48.48%(P <0.05)。治疗后,联合组血清CEA、 CA125、 CYFRA21-1水平均低于常规组(P <0.05)。治疗后,联合组肺癌患者生存质量测定量表(FACT-L)评分高于常规组(P <0.05)。结论 贝伐珠单抗联合化疗方案用于治疗NSCLC患者,可明显提升临床疗效,降低患者血清CEA、 CA125、 CYFRA21-1水平,提高其生存质量。

厄洛替尼联合贝伐珠单抗一线治疗EGFR敏感突变阳性晚期非小细胞肺癌的临床观察

目的观察厄洛替尼联合贝伐珠单抗一线治疗表皮生长因子受体(EGFR)敏感突变阳性晚期非小细胞肺癌的临床效果。方法采用前瞻性随机对照研究,选择EGFR敏感突变阳性晚期非小细胞肺癌患者作为研究对象。采用随机数字表法将患者分为对照组与观察组,对照组采用厄洛替尼治疗,观察组采用厄洛替尼联合贝伐珠单抗治疗。比较2组患者临床疗效、血清肿瘤标志物水平[癌胚抗原(CEA)、细胞角蛋白21-1片段(CYFRA21-1)、血管内皮生长因子(VEGF)]、免疫功能[白细胞分化抗原3(CD3)、白细胞分化抗原4(CD4)、白细胞分化抗原8(CD8)]以及用药不良反应情况。结果治疗3个月后,观察组患者客观缓解率(ORR)、疾病控制率(DCR)均高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组血清CEA、CYFRA21-1、VEGF水平低于对照组,差异有统计学意义(P<0.05);观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于对照组,CD8^(+)低于对照组,差异有统计学意义(P<0.05)。2组患者治疗不良反应发生率比较,差异无统计学意义(P>0.05)。结论厄洛替尼联合贝伐珠单抗一线治疗EGFR敏感突变阳性晚期非小细胞肺癌可以有效提高临床疗效,改善患者免疫功能。

基于CT及血清肿瘤标志物及生活质量评价贝伐珠单抗联合一、二线化疗治疗转移性结直肠癌的疗效研究

目的:基于CT、血清肿瘤标志物及生活质量评价贝伐珠单抗联合一、二线化疗治疗转移性结直肠癌(CRC)的疗效。方法:回顾性分析2019年1月-2023年1月我院收治的90例转移性CRC患者临床资料,按照治疗方案不同将其分为一线组(n=60,给予贝伐珠单抗+含奥沙利铂药物治疗方案)、二线组(n=20,给予含伊立替康药物治疗方案)和跨线组(n=10,给予贝伐珠单抗+含奥沙利铂药物治疗,进展后应用贝伐珠单抗+含伊立替康药物治疗方案),比较3组治疗后的CT增强值、生活质量评分、血清肿瘤标记物水平及临床疗效。结果:治疗后,3组CT增强值均显著降低(P<0.05),SF-36生活质量量表评分均显著升高(P<0.05),且CT增强值为一线组<跨线组<二线组(P<0.05),SF-36评分为一线组>跨线组>二线组(P<0.05)。治疗后,3组癌胚抗原(CEA)、糖类抗原125(CA12-5)、糖类抗原199(CA19-9)水平均显著降低(P<0.05),且标记物水平为一线组<跨线组<二线组(P<0.05)。治疗后,3组客观缓解率(ORR)、疾病控制率(DCR)比较,差异均无统计学意义(P>0.05)。结论:贝伐珠单抗联合一线或二线化疗治疗转移性CRC均有确切效果,但在一线治疗中使用更利于降低患者CT增强值和血清肿瘤标记物水平,提高生活质量,值得推荐。