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開催概要
開催回
第58回・2020年・京都
 

大腸癌肝転移における抗VEGF抗体による肝類洞血小板凝集効果と肝切除

演題番号 : WS20-4

[筆頭演者]
永坂 岳司:1 
[共同演者]
田中 健大:2、母里 淑子:3、谷岡 洋亮:1、堅田 洋佑:1、佐野 史典:1、岡脇 誠:1、山村 真弘:1、吉田 一博:4、重安 邦俊:4、楳田 祐三:4、山口 佳之:1

1:川崎医科大学・臨床腫瘍学、2:岡山大学・病理学、3:埼玉医科大学総合医療センター・臨床遺伝学、4:岡山大学・消化器外科

 

Background: Efficacy of RAM is widely probed not only in patients with advanced metastatic CRC but also in patients with other malignancies, e.g., lung, gastric and hepatocellular carcinoma. In this study, we assessed the potential role of RAM contained chemotherapy with respect to liver metastases (LM) in second-line or salvage-line in patients with advanced CRC.
Methods: A cohort of 36 CRC patients who received RAM with FOLFIRI in second-line or salvage-line were enrolled. Efficacies were evaluated by PFS, OS, ORR, and the resection rate of LM. IHC for CD42b was used to estimate an efficacy of anti-proangiogenic effects around LM.
Results: RAS mutations were found in 23 patients (64%). Of 36 CRC patients, 21 (58%) received RAM with FOLFIRI in the second-line (the second-RAM group) while 15 patients (42%) in salvage-line (the salvage-RAM group). Median overall survival after induction of RAM based chemotherapy was 23 months (95% CI: 12-34) in the second-RAM group and 8 months (95% CI: 5-19) in the salvage-RAM group. Of 36 patients, 14 patients (39%) had experienced surgical resection for LM during the series of chemotherapies. Among them, 6 patients received surgical resection for LM during the second-line RAM with FOLFIRI (the RAM-LM group). Of rest 8 patients who had experienced surgical resection for LM during the first-line chemotherapy, and 6 patients had been treated with bevacizumab-based chemotherapy (the BEV-LM group). IHC of CD42b revealed that the median value of platelet aggregation score was significantly higher in the RAM-LM group (the median value of platelet aggregation score = 3, range 0-3) than the BEV-LM group (the median value of platelet aggregation score = 1, range 0-3, p=0.011).
Conclusion: Our result suggests that, despite of second-line usage, RAM lend support to surgical resection for LM by inducing platelet aggregation in liver sinusoid around LM.

キーワード

臓器別:大腸・小腸

手法別:化学療法

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