BRAF基因状态与西妥昔单抗联合化疗治疗晚期大肠癌疗效之间的关系

doi:10.3969/j.issn.1006-6233.2018.04.015

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摘要 目的:探讨BRAF基因状态与西妥昔单抗联合化疗治疗晚期大肠癌疗效之间的关系。方法:将120例晚期大肠癌患者随机分为2组,A组61例患者KRAS、NRAS、BRAF基因为野生型,使用西妥昔单抗联合FOLFIRI(伊立替康、亚叶酸钙、5-氟尿嘧啶)方案,B组59例患者KRAS、NRAS基因为野生型,BRAF基因为突变型,同样使用西妥昔单抗联合FOLFIRI方案,比较两组患者的近期疗效、肿瘤进展时间(TTP)、总生存时间(OS)及不良反应。结果:A组患者的客观缓解率(ORR)、疾病控制率(DCR)、TTP、OS分别为45.9%、83.6%、10.5个月、18.8个月,B组患者的客观缓解率(ORR)、疾病控制率(DCR)、TTP、OS分别为42.4%、78.0%、9.1个月,18.5个月,均低于A组,但差异无统计学意义(P>0.05);两组患者的不良反应主要为痤疮样皮疹、消化道及血液学毒性,以Ⅰ~Ⅱ度为主,差异均无统计学意义(P>0.05)。结论:检测BRAF基因状态有利于进一步预测西妥昔单抗在晚期大肠癌中的价值,可能影响患者的治疗选择和预后。

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关键词 ： BRAF基因, 西妥昔单抗, 晚期结直肠癌

Abstract：Objective: To explore the relationship between BRAF gene status and efficacy of cetuximab combined with chemotherapy in the treatment of advanced colorectal cancer. Methods: 120 patients with advanced colorectal cancer were randomly divided into 2 groups. In group A, 61 cases of KRAS, NRAS, BRAF genes were wild type, using cetuximab combined with FOLFIRI (irinotecan, leucovorin, 5- fluorouracil) scheme; in group B, KRAS, NRAS genes were wild type in 59 cases, and BRAF gene was mutant, also using cetuximab combined with FOLFIRI scheme. The short-term efficacy, time to progression (TTP), overallsurvival (OS) and adverse reactions were compared between the two groups. Results: The objective response rate (ORR) and disease control rate (DCR) in group A and group B were 45.9%&42.4% and 83.6%&78.0%, respectively. TTP and OS in group A and group B were 10.5&9.1 months and 18.8&18.5 months, respectively. The results of A group were slightly better than those of group B, but there were no significant differences (P>0.05). The main adverse reactions of the two groups were acne like rash, digestive tract and hematological toxicity, mainly I-II degrees, but there were no statistical differences (P>0.05). Conclusion: Detection of BRAF gene status is helpful to further predict the value of cetuximab in advanced colorectal cancer, which may influence the treatment choice and prognosis of patients.

Key words： BRAF gene Cetuximab Advanced colorectal cancer

通讯作者: 杨健

引用本文:

丁萍, 杨健, 周炎, 顾贤成, 邓建良, 王维民. BRAF基因状态与西妥昔单抗联合化疗治疗晚期大肠癌疗效之间的关系[J]. 河北医学, 2018, 24(4): 583-587.
DING Ping, YANG Jian, ZHOU Yan, et al. Relationship between BRAF Gene Status and Efficacy of Cetuximab Combined with Chemotherapy in the treatment of Advanced Colorectal Cancer. HeBei Med, 2018, 24(4): 583-587.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2018.04.015 或 http://www.hbyxzzs.cn/CN/Y2018/V24/I4/583

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