医学
福尔菲里
伊立替康
内科学
肿瘤科
福克斯
贝伐单抗
转移瘤切除术
结直肠癌
威罗菲尼
西妥昔单抗
养生
V600E型
无进展生存期
克拉斯
奥沙利铂
癌症
化疗
突变
转移性黑色素瘤
生物化学
化学
基因
作者
Yuqiu Xu,Guiying Wang,Xuzhi Zheng,Wenju Chang,Jihong Fu,Tao Zhang,Lin Qi,Yang Lv,Zhehui Zhu,Wentao Tang,Jiacheng Xu
出处
期刊:Ejso
[Elsevier]
日期:2023-11-01
卷期号:49 (11): 106981-106981
被引量:1
标识
DOI:10.1016/j.ejso.2023.07.007
摘要
BRAF V600E mutant-metastatic colorectal cancer (mCRC) is characterized by its short survival time. Treatment approaches vary depending on whether or not the metastases are initially resectable. The benefit of metastasectomy remains unclear, and the optimal first-line treatment is controversial. This study aimed to describe the prognosis of BRAF V600E mutant-mCRC, analyze the recurrence pattern in resectable patients, and explore the optimal first-line treatment for unresectable patients.Patients diagnosed with BRAF V600E mutant-mCRC between February 2014 and January 2022 in five hospitals were enrolled. Date on clinical and pathological characteristics, treatment features, and survival outcomes were collected.Of the 220 included patients, 64 initially resectable patients had a significantly longer overall survival (OS) (37.07 vs. 20.20 months, P < 0.001) than initially unresectable patients. Of 156 unresectable patients, 54 received doublet (FOLFOX, XELOX or FOLFIRI) or triplet (FOLFOXIRI) chemotherapies (Chemo), 55 received Chemo plus Bevacizumab (Chemo+Bev), and 33 received vemurafenib plus cetuximab and irinotecan (VIC). The VIC regimen had a better progression-free survival (PFS) (12.70 months) than the Chemo (6.70 months, P < 0.001) and Chemo+Bev (8.8 months, P = 0.044) regimens. Patients treated with VIC had the best overall response rate (60.16%, P < 0.001), disease control rate (93.94%, P < 0.001) and conversional resection rate (24.24%, P = 0.003).Metastasectomy is beneficial to the survival of patients with BRAF V600E mutant-mCRC. For initially unresectable patients, VIC as first-line therapy is associated with a better prognosis and efficacy than doublet and triplet chemotherapy with or without bevacizumab.
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