演題抄録

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開催概要
開催回
第56回・2018年・横浜
 

切除不能進行再発大腸癌に対するVEGF阻害薬の治療成績比較と適正使用の検討

演題番号 : P18-1

[筆頭演者]
演者)小澤 大悟:1 
[共同演者]
山田 和之介:1、鈴木 雅貴:1、小川 敦:1、深井 康幸:1、持田 泰:1、尾嶋 仁:1

1:群馬県立がんセンター・消化器外科

 

[Background]In the treatment of advanced colorectal cancer, Ramucirumab and Aflibersept as well as Bevacizumab have been insurance approved and used recently in Japan. Although clinical trials have proved the usefulness of each drug, there is not enough evidence on the distinction between VEGF inhibitors.[Materials and Methods]137 cases in which VEGF inhibitor + FOLFIRI (Bmab; 91, Rmab; 24, Afli; 22) was used against advanced colorectal cancer in our department in January 2012 to March 2018 were included. Therapeutic effects of VEGF inhibitor (PFS, RR, DCR, AE etc.) were retrospectively examined considering anti-VEGF use history (pre-Bmab used, or not used) and treatment line (2nd line / 3rd line-).[Results]There is no difference in age and sex between antiVEGF 3 groups. In the Bmab group, the proportion used in 2nd line was high (P <0.01), and anti-VEGF unused rate in pretreatment was high (P <0.01). It seems to be due to the transition of the treatment method. PFS was predominantly better in the Bmab group in all cases analysis (MST Bmab; 5.4 months, Rmab; 2.7 months, Afli; 3.4 months, P <0.01), it seems to be due to the use conditions mentioned above. Pre-VEGF(-)2nd line group (Bmab;7.7m, Afli;4.6m, P=0.04), pre-VEGF(+)2nd line (B;4.6m, R;3.7m, A;3.5m, P=0.93), pre-VEGF(-)3rd- (B;4.2m, A;2.8m, P=0.08), pre-VEGF(+)3rd- (B;3.5m, R;2.3m, A;3.3m, P=0.52).[Discussion]There was no clear difference in the therapeutic effect between antiVEGF or slightly Bmab was predominant. Differences in tolerability depending on the extent of adverse events may be related to outcome. From this study, no clear knowledge on the usage of the new VEGF inhibitors can be obtained, but it can be used separately by new biomarkers such as VEGF-D in the future. In cases after 3rd line which became refractory to CPT-11, since PFS is short and DCR is poor, changes to Regorafenib or TAS-102 should also be considered.

キーワード

臓器別:大腸・小腸

手法別:化学療法

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