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FOLFOXIRI reintroduction in metastatic colorectal cancer.
The Lancet Oncology ( IF 41.6 ) Pub Date : 2020-03-09 , DOI: 10.1016/s1470-2045(20)30087-5 Rob Glynne-Jones 1 , Mark Harrison 1
The Lancet Oncology ( IF 41.6 ) Pub Date : 2020-03-09 , DOI: 10.1016/s1470-2045(20)30087-5 Rob Glynne-Jones 1 , Mark Harrison 1
Affiliation
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FOLFOXIRI (fluorouracil, leucovorin, oxaliplatin, and irinotecan) is an effective first-line combination therapy for metastatic colorectal cancer that offers better outcomes in terms of overall response rate, progression-free survival, and overall survival compared with standard doublet chemotherapy. However, this improvement comes at the price of more toxicity. The TRIBE trial showed that FOLFOXIRI plus bevacizumab significantly improved progression-free survival compared with FOLFIRI (fluorouracil, leucovorin, and irinotecan) plus bevacizumab. Longer median overall survival was reported in patients with RAS and BRAF wild-type cancers compared with mutated cancers, but the treatment effect from the strategy itself was not significantly different between the molecular subgroups. These results suggest that if the TRIBE strategy is adopted the baseline RAS and BRAF-mutational status does not need to be considered. However, the role of additional targeted drugs combined with FOLFOXIRI remains uncertain—particularly anti-EGFR drugs. There are ongoing phase 3 trials of modified FOLFOXIRI plus panitumumab regimen versus mFOLFOX6 (fluorouracil, leucovorin, and oxaliplatin) plus panitumumab in patients with unresectable RAS and BRAF wild-type metastatic colorectal cancer.
中文翻译：
FOLFOXIRI重新引入转移性结直肠癌。
FOLFOXIRI（氟尿嘧啶，亚叶酸钙，奥沙利铂和伊立替康）是一种有效的转移性结直肠癌一线联合治疗，与标准双线化疗相比，其总反应率，无进展生存期和总生存期更好。但是，这种改善是以牺牲更多毒性为代价的。TRIBE试验显示，与FOLFIRI（氟尿嘧啶，亚叶酸钙和伊立替康）加贝伐单抗相比，FOLFOXIRI加贝伐单抗显着改善了无进展生存期。据报道，RAS和BRAF患者的中位总生存期更长野生型癌症与突变型癌症相比，但是该策略本身的治疗效果在分子亚组之间没有显着差异。这些结果表明，如果采用TRIBE策略，则无需考虑基线RAS和BRAF突变状态。然而，其他靶向药物联合FOLFOXIRI的作用仍不确定，尤其是抗EGFR药物。正在进行中的改良FOLFOXIRI加帕尼单抗方案与mFOLFOX6（氟尿嘧啶，亚叶酸和奥沙利铂）加帕尼单抗联合不可切除RAS和BRAF野生型转移性结直肠癌患者的3期试验正在进行中。
更新日期：2020-03-31
中文翻译：
FOLFOXIRI重新引入转移性结直肠癌。
FOLFOXIRI（氟尿嘧啶，亚叶酸钙，奥沙利铂和伊立替康）是一种有效的转移性结直肠癌一线联合治疗，与标准双线化疗相比，其总反应率，无进展生存期和总生存期更好。但是，这种改善是以牺牲更多毒性为代价的。TRIBE试验显示，与FOLFIRI（氟尿嘧啶，亚叶酸钙和伊立替康）加贝伐单抗相比，FOLFOXIRI加贝伐单抗显着改善了无进展生存期。据报道，RAS和BRAF患者的中位总生存期更长野生型癌症与突变型癌症相比，但是该策略本身的治疗效果在分子亚组之间没有显着差异。这些结果表明，如果采用TRIBE策略，则无需考虑基线RAS和BRAF突变状态。然而，其他靶向药物联合FOLFOXIRI的作用仍不确定，尤其是抗EGFR药物。正在进行中的改良FOLFOXIRI加帕尼单抗方案与mFOLFOX6（氟尿嘧啶，亚叶酸和奥沙利铂）加帕尼单抗联合不可切除RAS和BRAF野生型转移性结直肠癌患者的3期试验正在进行中。
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