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Хирургия и онкология

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ПЕРВАЯ ЛИНИЯ ЛЕЧЕНИЯ БОЛЬНЫХ МЕТАСТАТИЧЕСКИМ НЕОПЕРАБЕЛЬНЫМ РАКОМ ТОЛСТОЙ КИШКИ

https://doi.org/10.17650/2220-3478-2014-0-4-8-15

Аннотация

Первая линия терапии метастатического рака толстой кишки (мРТК) является самой важной для пациента. Медиана ее времени до прогрессирования составляет большую часть продолжительности жизни пациента. Естественно, необходимо выбирать наиболее эффективные комбинации таргетных препаратов и химиотерапевтических режимов. Выбор терапии больных раком толстой кишки определяется как клиническими характеристиками заболевания, так и молекулярными изменениями в опухоли. За последний год появилось много данных по применению таргетных препаратов в различных клинических ситуациях, опубликованы результаты сравнительных исследований различных комбинаций лечебных опций. Все это определяет переосмысливание выбора режима лечения больных у больных мРТК, именно этому и посвящен настоящий обзор.

Об авторах

М. Ю. Федянин
ФГБНУ «РОНЦ им. Н.Н. Блохина», Москва
Россия


А. А. Трякин
ФГБНУ «РОНЦ им. Н.Н. Блохина», Москва
Россия


С. А. Тюляндин
ФГБНУ «РОНЦ им. Н.Н. Блохина», Москва
Россия


Список литературы

1. Schmoll H.J., Van Cutsem E., Stein A. et al. ESMO Consensus Guidelines for management of patients with colon and rectal cancer. A personalized approach to clinical decision making. Ann Oncol 2012;23(10):2479–516.

2. Mendelsohn J., Baselga J. Status of epidermal growth factor receptor antagonists in the biology and treatment of cancer. J Clin Oncol 2003;21(14):2787–99.

3. Custodio A., Feliu J. Prognostic and predictive biomarkers for epidermal growth factor receptor-targeted therapy in colorectal cancer: beyond KRAS mutations. Crit Rev Oncol Hematol 2013;85(1):45–81.

4. Lievre A., Bachet J.B., Boige V. et al. KRAS mutations as an independent prognostic factor in patients with advanced colorectal cancer treated with cetuximab. J Clin Oncol 2008;26:374–9.

5. De Roock W., Jonker D., Di Nicolantonio F. et al. Association of KRAS p.G13D mutation with outcome in patients with chemotherapyrefractory metastatic colorectal cancer treated with cetuximab. JAMA 2010;304(16): 1812–20.

6. Tejpar S., Celik I., Schlichting M. et al. Association of KRAS G13D tumor mutations with outcome in patients with metastatic colorectal cancer treated with first-line chemotherapy with or without cetuximab. J Clin Oncol 2012;30:3570–7.

7. Peeters M., Douillard J., Van Cutsem E. et al. Mutant KRAS codon 12 and 13 alleles in patients with metastatic colorectal cancer: assessment as prognostic and predictive biomarkers of response to panitumumab. J Clin Oncol 2013 Feb 20;31(6):759–65.

8. Schirripa M., Lonardi S., Cremolini C. et al. Phase II study of single-agent cetuximab in KRAS G13D mutant metastatic colorectal cancer (mCRC). J Clin Oncol 2014;32:5s (suppl; abstr 3524).

9. Douillard J.Y., Oliner K.S., Siena S. et al. Panitumumab-FOLFOX4 treatment and RAS mutations in colorectal cancer. N Engl J Med 2013;369:1023–34.

10. Douillard J.Y., Siena S., Tabernero J. et al. Overall survival (OS) and tumor shrinkage outcomes in patients with symptomatic/asymptomatic metastatic colorectal cancer (MCRC): data from the PRIME study. Ann Oncol 2013;24(4):iv25–iv50.

11. Ciardiello F., Lenz H.J., Kohne C.H. et al. Treatment outcome according to tumor RAS mutation status in CRYSTAL study patients with metastatic colorectal cancer (mCRC) randomized to FOLFIRI with/without cetuximab. J Clin Oncol 2014;32:5s(suppl; abstr 3506).

12. Tejpar S., Lenz H.J., Kohne C.H. et al. Effect of KRAS and NRAS mutations on treatment outcomes in patients with metastatic colorectal cancer (mCRC) treated first-line with cetuximab plus FOLFOX4: New results from the OPUS study. J Clin Oncol 2014;32(suppl 3; abstr LBA444).

13. Patterson S.D., Peeters M., Siena S. et al. Comprehensive analysis of KRAS and NRAS mutations as predictive biomarkers for single agent panitumumab (pmab) response in a randomized, phase III metastatic colorectal cancer (mCRC) study (20020408). J Clin Oncol 2013;31(suppl; abstr 3617).

14. Peeters M., Siena S., Tabernero J. et al. Survival outcomes in the PRIME study for patients (pts) with RAS/BRAF wild-type (WT) metastatic colorectal cancer (mCRC), by baseline Eastern Cooperative Oncology Group (ECOG) performance status (PS). J Clin Oncol 2014;32:5s(suppl; abstr 3557^).

15. Douillard J.Y., Tabernero J., Siena S. et al. Survival outcomes in patients (pts) with KRAS/NRAS (RAS) wild-type (WT) metastatic colorectal cancer (mCRC) and non-liver-limited disease (non-LLD): Data from the PRIME study. J Clin Oncol 2014;32:5s(suppl; abstr 3550^).

16. Artale S., Sartore-Bianchi A., Veronese S.M. et al. Mutations of KRAS and BRAF in primary and matched metastatic sites of colorectal cancer. J Clin Oncol 2008;26(25):4217–9.

17. Kopetz S., Overman M.J., Chen K. et al. Mutation and copy number discordance in primary versus metastatic colorectal cancer (mCRC). J Clin Oncol 2014;32:5s(suppl; abstr 3509).

18. Graham D.M., Arseneault M., Sukhai M.A. et al. Analysis of clonal evolution in colorectal cancer. J Clin Oncol 2014;32:5s(suppl; abstr 3510).

19. Morelli M.P., Overman M.J., Dasari A. et al. Heterogeneity of acquired KRAS and EGFR mutations in colorectal cancer patients treated with anti-EGFR monoclonal antibodies. J Clin Oncol 2013;31(suppl; abstr 3512).

20. Bokemeyer C., Van Cutsem E., Rougier P. et al. Addition of cetuximab to chemotherapy as first-line treatment for KRAS wild-type metastatic colorectal cancer: Pooled analysis of the CRYSTAL and OPUS randomized clinical trials. Eur J Cancer 2012;48:1466–75.

21. Oliner K., Douillard J., Siena S. et al. Analysis of KRAS/NRAS and BRAF mutations in the phase III PRIME study of panitumumab and FOLFOX vs FOLFOX as first line treatment for metastatic colorectal cancer. ASCO Annual Meeting 2013, Abstract 3511.

22. Seymour M.T., Brown S.R., Richman S. et al. Addition of panitumumab to irinotecan: results of PICCOLO, a randomized controlled trial in advanced colorectal cancer (aCRC). J Clin Oncol 2011;29 (Suppl) [abstract 3523].

23. Tol J., Dijkstra J.R., Klomp M. et al. Markers for EGFR pathway activation as predictor of outcome in metastatic colorectal cancer patients treated with or without cetuximab. Eur J Cancer 2010;46:1997–2009.

24. Di Nicolantonio F., Martini M., Molinari F. et al. Wild-type BRAF is required for response to panitumumab or cetuximab in metastatic colorectal cancer. J Clin Oncol 2008;26: 5705–12.

25. De Roock W., Claes B., Bernasconi D. et al. Effects of KRAS, BRAF, NRAS and PIK3CA mutations on the efficacy of cetuximab plus chemotherapy in chemotherapy-refractory metastatic colorectal cancer: a retrospective consortium analysis. Lancet Oncol 2010;11:753–62.

26. Yuan Z.X., Wang X.Y., Qin Q.Y. et al. The prognostic role of BRAF mutation in metastatic colorectal cancer receiving anti-EGFR monoclonal antibodies: a metaanalysis. PLoS One 2013;8(6):e65995. doi:10.1371/journal.pone.0065995.

27. Mao C., Liao R.Y., Qiu L.X. et al. BRAF V600E mutation and resistance to anti-EGFR monoclonal antibodies in patients with metastatic colorectal cancer: a meta-analysis. Mol Biol Rep 2011;38:2219–23.

28. Xu Q., Xu A.T., Zhu M.M. et al. Predictive and prognostic roles of BRAF mutation in patients with metastatic colorectal cancer treated with anti-epidermal growth factor receptor monoclonal antibodies: a metaanalysis. J Dig Dis 2013;14:409–16.

29. Loupakis F., Cremolini C., Salvatore L. et al. FOLFOXIRI plus bevacizumab as firstline treatment in BRAF mutant metastatic colorectal cancer. Eur J Cancer 2014;50(1): 57–63.

30. Loupakis F., Cremolini C., Lonardi S. et al. Subgroup analyses in RAS mutant, BRAF mutant and all-wt mCRC pts treated with FOLFOXIRI plus bevacizumab (bev) or FOLFIRI plus bev in the TRIBE study. J Clin Oncol 2014;32:5s(suppl; abstr 3519).

31. Liu L., Shi H., Bleam M.R. et al. Antitumor effects of dabrafenib, trametinib, and panitumumab as single agents and in combination in BRAF-mutant colorectal carcinoma (CRC) models. J Clin Oncol 2014;32:5s(suppl; abstr 3513).

32. Geel R.V., Elez E., Bendell J.C. et al. Phase I study of the selective BRAFV600 inhibitor encorafenib (LGX818) combined with cetuximab and with or without the α-specific PI3K inhibitor BYL719 in patients with advanced BRAF-mutant colorectal cancer. J Clin Oncol 2014;32:5s(suppl; abstr 3514).

33. Bendell J.C., Atreya C.E., Andrй T. et al. Efficacy and tolerability in an open-label phase I/II study of MEK inhibitor trametinib (T), BRAF inhibitor dabrafenib (D), and anti-EGFR antibody panitumumab (P) in combination in patients (pts) with BRAF V600E mutated colorectal cancer (CRC). J Clin Oncol 2014;32:5s(suppl; abstr 3515).

34. Hong D.S., Morris V.K., Fu S. et al. Phase 1B study of vemurafenib in combination with irinotecan and cetuximab in patients with BRAF-mutated advanced cancers and metastatic colorectal cancer. J Clin Oncol 2014;32:5s (suppl; abstr 3516).

35. Tabernero J., Chan E., Baselga J. et al. VE-BASKET, a Simon 2-stage adaptive design, phase II, histology-independent study in nonmelanoma solid tumors harboring BRAF V600 mutations (V600m): Activity of vemurafenib (VEM) with or without cetuximab (CTX) in colorectal cancer (CRC). J Clin Oncol 2014;32:5s(suppl; abstr 3518^).

36. Corcoran R.B., Atreya C.E., Falchook G.S. et al. Phase 1-2 trial of the BRAF inhibitor dabrafenib (D) plus MEK inhibitor trametinib (T) in BRAF V600 mutant colorectal cancer (CRC): Updated efficacy and biomarker analysis. J Clin Oncol 2014;32:5s(suppl; abstr 3517).

37. Федянин М.Ю., Трякин А.А., Тюляндин С.А. Перспективы лечения больных раком толстой кишки с мутацией в гене BRAF. Онкологическая колопроктология 2014;3:9–16.

38. Schwartzberg L., Rivera F., Karthaus M. et al. Analysis of KRAS/NRAS mutations in PEAK: A randomized phase II study of FOLFOX6 plus panitumumab (pmab) or bevacizumab (bev) as first-line treatment (tx) for wild-type (WT) KRAS (exon 2) metastatic colorectal cancer (mCRCJ Clin Oncol 2013;31(suppl; abstr 3631).

39. Rivera F., Schwartzberg L.S., Karthaus M. et al. Extended RAS analysis and subsequent anti-EGFR and anti-VEGF treatment (tx) in PEAK: A first-line phase 2 study of FOLFOX6 + panitumumab (pmab) or bevacizumab (bev) in metastatic colorectal cancer (mCRC). J Clin Oncol 2014;32:5s(suppl; abstr 3629).

40. Heinemann V., von Weikersthal L.F., Decker T. et al. FOLFIRI plus cetuximab versus FOLFIRI plus bevacizumab as first-line treatment for patients with metastatic colorectal cancer (FIRE-3): a randomised, open-label, phase 3 trial. Lancet Oncol 2014;15:1065–75.

41. Stintzing S., Modest D., von Weikersthal L.F. et al. Independent radiological evaluation of objective response, early tumor shrinkage, and depth of response in FIRE-3 (AIO KRK-0306) in the final RAS evaluable population. ESMO 2014; abstr LBA11.

42. Venook A.P., Niedzwiecki D., Lenz H.J. et al. CALGB/SWOG 80405: Phase III trial of irinotecan/5-FU/leucovorin (FOLFIRI) or oxaliplatin/5-FU/leucovorin (mFOLFOX6) with bevacizumab (BV) or cetuximab (CET) for patients (pts) with KRAS wild-type (wt) untreated metastatic adenocarcinoma of the colon or rectum (MCRC). J Clin Oncol 2014;32:5s(suppl; abstr LBA3).

43. Venook A., Niedzwiecki D., Lenz H. et al. CALGB/SWOG 80405: Analysis of patients undergoing surgery as part of treatment strategy. ESMO 2014 (abstr LBA10). 44. Lenz H., Niedzwiecki D., Innocenti F. et al. CALGB/SWOG 80405: Phase III trial of irinotecan/5-FU/leucovorin (FOLFIRI) or oxaliplatin/5-FU/leucovorin (mFOLFOX6) with bevacizumab (BV) or cetuximab (CET) for patients (pts) with untreated metastatic adenocarcinoma of the colon or rectum (MCRC): Expanded ras analyses. ESMO 2014 abstr 501O.


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