医脉通编译，转载请务必注明出处

2016年6月3-7日，一年一度的美国临床肿瘤学会（American Society of Clinical Oncology，ASCO）年会在芝加哥举办。6月4日上午的消化系统（结直肠）肿瘤壁报专场上，中山大学肿瘤防治中心的Wen zhuo He教授在壁报上呈现了一项摘要号为3593的研究，该试验在转移性结直肠癌患者中对原发肿瘤位置和贝伐珠单抗有效性进行了探索，医脉通整理如下：

研究人员之前报道过，贝伐珠单抗的有效性与转移性结直肠癌（mCRC）原发肿瘤位置有关。然而，当患者根据原发肿瘤位置进行分组时，一些重要的临床和病理特征是不均衡的。

从2004年到2013年，研究人员确认了740例接受以奥沙利铂或者伊立替康为基础化疗（CT组）的mCRC患者，244例接受贝伐珠单抗+奥沙利铂或者伊立替康为基础化疗作为一线治疗（CT+B组）的患者，他们来自中山大学肿瘤防治中心。研究人员应用以不平衡特征（性别，黏液组织学，确诊时分期和乳酸脱氢酶）为基础的倾向评分分析选择患者。主要终点是总生存期（OS）。Kaplan-Meier曲线和log-rank检验用来检出差异性。最后一次随访是在2015年12月30日进行。

58例右半结肠，86例左半结肠和99例直肠癌患者被纳入CT组（一共243例），78例右半结肠，86例左半结肠和80例直肠患者中纳入CT+B组（一共244例）。而只有当原发肿瘤位置处于右半结肠时，CT+B组患者与CT组比较有类似的OS（中位OS：CT+B组20.2个月 vs CT组20.5个月，P=0.851）。对于左半结肠癌患者来说，CT+B组的OS长于CT组（26.3个月 vs 23.1个月，P=0.021）。对于直肠癌患者来说，与CT组相比较，显著较长的OS仅在CT+B组观察到（26.3个月 vs 21.1个月，P=0.014）。

因此，这项试验的数据表明，右半结肠癌患者不能从贝伐珠单抗添加中取得生存获益，在右半和左半结肠癌之间对贝伐珠单抗的不同响应并非是由常规临床和病理特征引起的。

会议专题》》》2016年ASCO年会专题报道

原文摘要：

Primary tumor location and bevacizumab effectiveness in metastatic colorectal cancer patients(Abstract3593)

Authors：Wen-zhuo He, Chang Jiang,et al

Session Type：Poster Session

Background: We previously reported that bevacizumab effectiveness was associated with the primary tumor location of metastatic colorectal cancer (mCRC). However, several important clinical and pathological features were not balanced when patients were grouped by the primary tumor location. 

Methods: From 2004 to 2013, we identified 740 patients with mCRC treated with oxaliplatin or irinotecan based chemotherapy (CT group) and 244 patients treated with bevacizumab plus oxaliplatin or irinotican based chemotherapy as first-line setting (CT + B group) from Sun Yat-sen university cancer center. We selected patients using propensity score analyses based on unbalanced characteristics (gender, mucinous histology, stage at diagnosis, and lactate dehydrogenase). The primary outcome was overall survival (OS). Kaplan-Meier curves with log-rank tests were used to detect difference. The last time follow-up was conducted at 30th December 2015. 

Results: 58 right-side colon, 86 left-side colon and 99 rectal cancer patients were included in CT group (total: 243) while 78 right-side colon, 86 left-side colon and 80 rectal cancer patients were included in CT + B group (total: 244). Patients in CT + B group had a similar OS in comparison with CT group only when the primary tumor located at right-side colon (median OS were 20.2 months for CT + B group versus 20.5 for CT group, P = 0.851). For left-side colon cancer patients, those in CT + B group had longer OS than CT group (26.3 versus 23.1 months, P = 0.021). For rectal cancer patients, significantly longer OS were also observed in CT + B than CT group (26.3 versus 21.1 months, P = 0.014). 

Conclusions: Our data suggested that patients with right-side colon cancer could not get survival benefit from the addition of bevacizumab, and the different response to bevacizumab between right-side and left-side colon cancer were not caused by routinely clinical and pathological features.

打开微信 →→ 添加“医脉通肿瘤科”公众号，或扫描电脑屏幕右上方二维码 →→ 关注医脉通肿瘤科。随时随地获取肿瘤前沿资讯，一次打包最实用的肿瘤治疗知识。做科研达人、临床高手，尽在医脉通肿瘤频道。