演題抄録

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開催概要
開催回
第56回・2018年・横浜
 

進行・再発大腸癌治療におけるRamucirumabの有用性の検討

演題番号 : P18-6

[筆頭演者]
演者)池辺 絢:1 
[共同演者]
小林 和真:1、伊藤 信一郎:1、井上 悠介:1、虎島 泰洋:1、哲翁 華子:1、崎村 千香:1、久芳 さやか:1、山口 峻:1、小坂 太一郎:1、足立 智彦:1、山之内 孝彰:1、金高 賢悟:1、高槻 光寿:1、江口 晋:1

1:長崎大学・移植・消化器外科

 

Background: Based on the result of the RAISE trial, Ramucirumab (Rmab) combined with FOLFIRI is recognized as the standard second-line chemotherapy (CT) for advanced or recurrent colorectal cancer (ARCC). In Japan, Rmab+FOLFIRI has been used in second-line therapy (ADEQUATE) for colorectal cancer since May 2016. However, some ARCC patients have already been treated with other second-line regimens. We have thus tried to treat these patients with Rmab in 3rd-or-later lines (OTHERS) to improve their survival. We examined the usefulness and validity of Rmab-containing CT focusing on the difference between pre-/post-Rmab and bevacizumab (Bmab) beyond progression (BBP). Methods: We retrospectively reviewed 18 ARCC patients using Rmab-containing regimens between July 2016 and March 2018. Results: The patients were a mean 63.0 years old (11 males and 7 females). Twelve patients were ADEQUATE, and six were OTHERS. The response rates were 8% (CR1/PR0/SD5/PD3/NE3) in ADEQUATE and 0% (CR0/PR0/SD3/PD3) in OTHERS (no significance). The median progression-free survival (PFS) was 451 days in ADEQUATE and 554 days in OTHERS (significance). The median survival time (MST) was 155 days in ADEQUATE and 95 days in OTHERS (significance). The median PFS and MST in ADEQUATE were similar to the results of the RAISE trial. The median PFS and MST in OTHERS were longer than with regorafenib or TFTD, which are now standard third- and fourth-line therapies. There was no significant difference in the OS between Rmab and BBP as second-line therapy. However, the OS of second-line Rmab and Bmab after first-line anti-EGFR regimens tended to be longer than that after Bmab alone (p=0.0953). Furthermore, the OS after first-line Rmab tended to be longer than the pre-Rmab value. Conclusions: These findings suggest that Rmab-containing regimens are useful as second-line as well as third-or-higher-line therapies, and using Rmab might help prolong the survival of ARCC.

キーワード

臓器別:大腸・小腸

手法別:化学療法

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