Clinical trial of irinotecan combined with capecitabine and bevacizumab in the treatment of colorectal cancer patients with liver metastases
10.13699/j.cnki.1001-6821.2024.18.011
- VernacularTitle:伊立替康联合卡培他滨和贝伐珠单抗治疗结直肠癌伴肝转移患者的临床研究
- Author:
Wei WANG
1
;
Jin-Kun CHENG
;
Zheng-Dao YANG
Author Information
1. 宁波市医疗中心李惠利医院肛肠外科,浙江宁波 315040
- Keywords:
oxaliplatin injection;
irinotecan hydrochloride injection;
capecitabine tablet;
colorectal cancer;
liver metastasis;
disease control rate;
vascular endothelial growth factor;
carbohydrate antigen 199
- From:
The Chinese Journal of Clinical Pharmacology
2024;40(18):2660-2664
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the efficacy of oxaliplatin and irinotecan combined with capecitabine and bevacizumab on disease control rate,serum vascular endothelial growth factor(VEGF)and carbohydrate antigen 199(CA199)in colorectal cancer(CRC)combined with liver metastases.Methods CRC patients with liver metastases and elevated CA199 were divided into control group and treatment group.The control group was given irinotecan hydrochloride injection(150 mg·m-2,iv infusion,D1)combined with capecitabine tablets(1 000 mg·m-2,oral,bid,D 1-D 14)and bevacizumab injection(7.5 mg·m-2,iv infusion,D1).The treatment group was given oxaliplatin injection(130 mg·m-2,iv infusion,D 1)combined with capecitabine tablets(1 000 mg·m-2,oral,bid,D 1-D 14)and bevacizumab injection(7.5 mg·m-2,iv infusion,D 1).All were treated for 4 cycles(21 d/cycle).The total response rate,disease control rate,progression-free survival(PFS),survival rate at 1 year after treatment,serum VEGF,CA199,and the occurrence of toxic and the safety were evaluated.Results The treatment group and the control group were included in 46 and 52 cases,respectively.Total response rates in treatment group and control group were 17.31％(9 cases/52 cases)13.04％(6 cases/46 cases),disease control rates were 59.62％(31 cases/52 cases)and 50.00％(23 cases/46 cases),the difference was not statistically significant(all P＞0.05).The median PFS in treatment group and control group at 1 year after treatment were 8.50 and 10.50 months;progression-free survival rate were 42.31％(22 cases/52 cases)and 30.43％(14 cases/46 cases);overall survival rates were 73.08％(38 cases/52 cases)and 67.39％(31 cases/46 cases),the difference was not statistically significant(all P＞0.05).After treatment,levels of serum VEGF in treatment group and control group were(442.59±67.90)and(518.56±82.08)pg·mL-1,CA199 levels were(73.85±13.66)and(92.28±16.17)U·mL-1,the difference were statistically significant(all P＜0.05).During treatment,the incidence of grade Ⅲ～Ⅳ diarrhea in oxaliplatin group and irinotecan group were 1.92％(1 case/52 cases)and 17.39％(8 cases/46 cases),respectively,the incidence of neutropenia were 15.38％(8 cases/52 cases)and 36.96％(17 cases/46 cases),respectively,the differences were statistically significant(all P＜0.05).There were no significant differences in nausea,vomiting,thrombocytopenia,anemia,peripheral neuropathy,hand-foot syndrome and alopecia between 2 groups(all P＞0.05).Conclusion Oxaliplatin and irinotecan respectively combined with capecitabine and bevacizumab have similar clinical curative effect and survival at 1 year after treatment in patients with CRC and liver metastasis.However,oxaliplatin and capecitabine combined with bevacizumab can significantly reduce serum VEGF,CA199 levels with higher safety.
