维持治疗在中晚期消化系统恶性肿瘤中的研究进展
摘要
对经标准治疗病情得以控制的中晚期消化系统恶性肿瘤进行维持治疗,可延长患者的生存期,提高生活质量。目前维持治疗的药物包括化疗药物、靶向药物、化疗药物联合靶向药物、双靶向药物及中医药等。氟尿嘧啶类似物因口服简便和不良反应小,在中晚期食管癌、晚期胃癌及转移性结直肠癌(mCRC)的维持治疗中应用较为广泛,且安全性良好。靶向药物在晚期胃癌的维持治疗中已开展小样本临床研究,结果值得期待。mCRC维持治疗的临床研究日趋成熟,单一化疗或靶向药物治疗、化疗联合靶向药物治疗及双靶向药物治疗为患者提供了更多维持治疗的选择。本文将对常见的晚期消化系统肿瘤如食管癌、胃癌及结直肠癌的维持治疗的新进展进行综述。
引文
[1]陈益力.中国恶性肿瘤发病和死亡分析[J].养生保健指南, 2018(50):274.
[2] Kasi PM, Grothey A. Chemotherapy maintenance[J]. Cancer J, 2016, 22(3):199-204.
[3]?sterborg A, Wierda WG, Mayer J, et al. Ofatumumab retreatment and maintenance in fludarabine-refractory chronic lymphocytic leukaemia patients[J]. Br J Haematol, 2015,170(1):40-49.
[4] Rossi A, Garassino MC, Cinquini M, et al. Maintenance or consolidation therapy in small-cell lung cancer:a systematic review and meta-analysis[J]. Lung Cancer, 2010, 70(2):119-128.
[5] Lim S, Lee S, Han J, et al. Prolonged clinical benefit from the maintenance hormone therapy in patients with metastatic breast cancer[J]. Breast, 2013, 22(6):1205-1209.
[6]朱以香,李峻岭.广泛期小细胞肺癌的维持治疗研究进展[J].癌症进展, 2017, 15(9):990-993.
[7] Domper Arnal MJ, Ferrández Arenasá, Lanas Arbeloaá.Esophageal cancer:risk factors, screening and endoscopic treatment in western and eastern countries[J]. World J Gastroenterol, 2015, 21(26):7933-7943.
[8]孙静波,宋丽杰,李向柯,等.一线化疗后S-1维持治疗晚期食管癌的疗效[J].肿瘤, 2016, 36:668-673.
[9]周艳刚,刘朝敏,唐樱,等.替吉奥胶囊维持治疗进展期食管癌临床观察[J].肿瘤研究与临床, 2016, 28(7):452-454.
[10]张旭,魏琳琳,刘飞.调强放疗联合化疗维持治疗中晚期食管癌的疗效分析[J].实用癌症杂志, 2014, 29(2):177-179.
[11]罗海涛.调强放疗联合多西他赛和顺铂化疗并卡培他滨维持治疗中晚期食管癌的临床观察[J/OL].中华临床医师杂志(电子版), 2013, 7(3):956-959[2018-06-21]. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&-id=zhlcyszz201303015.
[12] Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2):115-132.
[13]王树滨,吴煊,陈晓秋,等.卡培他滨和替吉奥作为晚期胃癌一线诱导化疗后维持治疗的临床观察[J].中国肿瘤临床, 2016, 43(20):913-917.
[14]郑礼平,张楠,潘莹,等.晚期胃癌卡培他滨或替吉奥维持治疗的临床研究[J].实用医学杂志, 2017, 33(16):2757-2760.
[15]惠双,郭宏强.晚期胃癌患者XELOX方案化疗后维持治疗的疗效及预后生存分析[J].癌症进展, 2017, 15(7):780-783.
[16] Li W, Zhao X, Wang H, et al. Maintenance treatment of uracil and tegafur(UFT)in responders following first-line fluorouracil-based chemotherapy in metastatic gastric cancer:a randomized phase II study[J]. Oncotarget, 2017, 8(23):37826-37834.
[17] Haag GM, Stocker G, Quidde J, et al. Randomized controlled trial of S-1 maintenance therapy in metastatic esophagogastric cancer-the multinational MATEO study[J]. BMC Cancer, 2017, 17(1):509.
[18] Palacio S, Loaiza-Bonilla A, Kittaneh M, et al. Successful use of trastuzumab with anthracycline-based chemotherapy followed by trastuzumab maintenance in patients with advanced HER2-positive gastric cancer[J]. Anticancer Res, 2014, 34(1):301-306.
[19] Meulendijks D, de Groot JW, Los M, et al. Bevacizumab combined with docetaxel, oxaliplatin, and capecitabine,followed by maintenance with capecitabine and bevacizumab, as first-line treatment of patients with advanced HER2-negative gastric cancer:a multicenter phase 2 study[J]. Cancer, 2016, 122(9):1434-1443.
[20] Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide:sources, methods and major patterns in GLOBOCAN 2012[J]. Int J Cancer, 2015,136(5):E359-E386.
[21] Chibaudel B, Maindrault-Goebel F, Lledo G, et al. Can chemotherapy be discontinued in unresectable metastatic colorectal cancer? The GERCOR OPTIMOX2 study[J]. J Clin Oncol, 2009, 27(34):5727-5733.
[22] Tournigand C, Cervantes A, Figer A, et al. OPTIMOX1:a randomized study of FOLFOX4 or FOLFOX7 with oxaliplatin in a stop-and-go fashion in advanced colorectal cancer--a GERCOR study[J]. J Clin Oncol, 2006, 24(3):394-400.
[23] Luo HY, Li YH, Wang W, et al. Single-agent capecitabine as maintenance therapy after induction of XELOX(or FOLFOX)in first-line treatment of metastatic colorectal cancer:randomized clinical trial of efficacy and safety[J].Ann Oncol, 2016, 27(6):1074-1081.
[24] Nakayama G, Kodera Y, Yokoyama H, et al. Modified FOLFOX6 with oxaliplatin stop-and-go strategy and oral S-1 maintenance therapy in advanced colorectal cancer:CCOG-0704 study[J]. Int J Clin Oncol, 2011, 16(5):506-511.
[25]董海鹏.替吉奥在晚期转移性结直肠癌维持治疗中的价值[J].中国实用医药, 2017, 12(24):106-107.
[26]孔凡龙.替吉奥维持治疗晚期结直肠癌的临床疗效及安全性评价[J].中国实用医药, 2017, 12(33):90-91.
[27]李绮云,吴兴焕,梁发,等.替吉奥与卡培他滨在晚期结直肠癌一线治疗后维持治疗的临床分析[J].赣南医学院学报, 2017, 37(1):66-69.
[28] Pfeiffer P, Sorbye H, Qvortrup C, et al. Maintenance therapy with cetuximab every second week in the first-line treatment of metastatic colorectal cancer:the NORDIC-7.5 study by the nordic colorectal cancer biomodulation group[J]. Clin Colorectal Cancer, 2015, 14(3):170-176.
[29]陈荣斌,叶汝兴,吴楚海,等.国产抗血管生成药物恩度单药维持治疗晚期结直肠癌综合疗效评价[J].中国医药导报, 2015, 12(14):121-124.
[30] Bendell JC, Joseph M, Barnes K, et al. A phase-2 trial of single agent axitinib as maintenance therapy following first-line treatment with modified FOLFOX/bevacizumab in patients with metastatic colorectal cancer[J]. Cancer Invest, 2017, 35(6):386-392.
[31] Grávalos C, Carrato A, Tobe?a M, et al. A randomized phase II study of axitinib as maintenance therapy after first-line treatment for metastatic colorectal cancer[J].Clin Colorectal Cancer, 2018, 17(2):e323-e329.
[32] Stein A, Schwenke C, Folprecht G, et al. Effect of application and intensity of bevacizumab-based maintenance after induction chemotherapy with bevacizumab for metastatic colorectal cancer:a meta-analysis[J]. Clin Colorectal Cancer, 2016, 15(2):e29-e39.
[33] Hegewisch-Becker S, Graeven U, Lerchenmüller CA, et al. Maintenance strategies after first-line oxaliplatin plus fluoropyrimidine plus bevacizumab for patients with metastatic colorectal cancer(AIO 0207):a randomised, non-inferiority, open-label, phase 3 trial[J]. Lancet Oncol, 2015,16(13):1355-1369.
[34] Goey KKH, Elias SG, Hinke A, et al. Clinicopathological factors influencing outcome in metastatic colorectal cancer patients treated with fluoropyrimidine and bevacizumab maintenance treatment vs observation:an individual patient data meta-analysis of two phase 3 trials[J]. Br J Cancer, 2017, 117(12):1768-1776.
[35] Nakayama G, Ishigure K, Yokoyama H, et al. The efficacy and safety of CapeOX plus bevacizumab therapy followed by capecitabine plus bevacizumab maintenance therapy in patients with metastatic colorectal cancer:a multi-center,single-arm, phase II study(CCOG-0902)[J]. BMC Cancer,2017, 17(1):243.
[36] Zhou M, Fu L, Zhang J. Who will benefit more from maintenance therapy of metastatic colorectal cancer?[J]. Oncotarget, 2017, 9(15):12479-12486.
[37] Tournigand C, Chibaudel B, Samson B, et al. Bevacizumab with or without erlotinib as maintenance therapy in patients with metastatic colorectal cancer(GERCOR DREAM; OPTIMOX3):a randomised, open-label, phase3 trial[J]. Lancet Oncol, 2015, 16(15):1493-1505.
[38] Hagman H, Fr?din JE, Berglund A, et al. A randomized study of KRAS-guided maintenance therapy with bevacizumab, erlotinib or metronomic capecitabine after first-line induction treatment of metastatic colorectal cancer:the Nordic ACT2 trial[J]. Ann Oncol, 2016, 27(1):140-147.
[39] Xu W, Gong Y, Kuang M, et al. Survival benefit and safety of bevacizumab in combination with erlotinib as maintenance therapy in patients with metastatic colorectal cancer:a meta-analysis[J]. Clin Drug Investig, 2017, 37(2):155-165.
[40]卞侠,郭海生,刘曰芬,等.参一胶囊联合卡培他滨维持治疗晚期大肠癌的临床研究[J].癌症进展, 2014, 12(6):589-592.
[2] Kasi PM, Grothey A. Chemotherapy maintenance[J]. Cancer J, 2016, 22(3):199-204.
[3]?sterborg A, Wierda WG, Mayer J, et al. Ofatumumab retreatment and maintenance in fludarabine-refractory chronic lymphocytic leukaemia patients[J]. Br J Haematol, 2015,170(1):40-49.
[4] Rossi A, Garassino MC, Cinquini M, et al. Maintenance or consolidation therapy in small-cell lung cancer:a systematic review and meta-analysis[J]. Lung Cancer, 2010, 70(2):119-128.
[5] Lim S, Lee S, Han J, et al. Prolonged clinical benefit from the maintenance hormone therapy in patients with metastatic breast cancer[J]. Breast, 2013, 22(6):1205-1209.
[6]朱以香,李峻岭.广泛期小细胞肺癌的维持治疗研究进展[J].癌症进展, 2017, 15(9):990-993.
[7] Domper Arnal MJ, Ferrández Arenasá, Lanas Arbeloaá.Esophageal cancer:risk factors, screening and endoscopic treatment in western and eastern countries[J]. World J Gastroenterol, 2015, 21(26):7933-7943.
[8]孙静波,宋丽杰,李向柯,等.一线化疗后S-1维持治疗晚期食管癌的疗效[J].肿瘤, 2016, 36:668-673.
[9]周艳刚,刘朝敏,唐樱,等.替吉奥胶囊维持治疗进展期食管癌临床观察[J].肿瘤研究与临床, 2016, 28(7):452-454.
[10]张旭,魏琳琳,刘飞.调强放疗联合化疗维持治疗中晚期食管癌的疗效分析[J].实用癌症杂志, 2014, 29(2):177-179.
[11]罗海涛.调强放疗联合多西他赛和顺铂化疗并卡培他滨维持治疗中晚期食管癌的临床观察[J/OL].中华临床医师杂志(电子版), 2013, 7(3):956-959[2018-06-21]. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&-id=zhlcyszz201303015.
[12] Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2):115-132.
[13]王树滨,吴煊,陈晓秋,等.卡培他滨和替吉奥作为晚期胃癌一线诱导化疗后维持治疗的临床观察[J].中国肿瘤临床, 2016, 43(20):913-917.
[14]郑礼平,张楠,潘莹,等.晚期胃癌卡培他滨或替吉奥维持治疗的临床研究[J].实用医学杂志, 2017, 33(16):2757-2760.
[15]惠双,郭宏强.晚期胃癌患者XELOX方案化疗后维持治疗的疗效及预后生存分析[J].癌症进展, 2017, 15(7):780-783.
[16] Li W, Zhao X, Wang H, et al. Maintenance treatment of uracil and tegafur(UFT)in responders following first-line fluorouracil-based chemotherapy in metastatic gastric cancer:a randomized phase II study[J]. Oncotarget, 2017, 8(23):37826-37834.
[17] Haag GM, Stocker G, Quidde J, et al. Randomized controlled trial of S-1 maintenance therapy in metastatic esophagogastric cancer-the multinational MATEO study[J]. BMC Cancer, 2017, 17(1):509.
[18] Palacio S, Loaiza-Bonilla A, Kittaneh M, et al. Successful use of trastuzumab with anthracycline-based chemotherapy followed by trastuzumab maintenance in patients with advanced HER2-positive gastric cancer[J]. Anticancer Res, 2014, 34(1):301-306.
[19] Meulendijks D, de Groot JW, Los M, et al. Bevacizumab combined with docetaxel, oxaliplatin, and capecitabine,followed by maintenance with capecitabine and bevacizumab, as first-line treatment of patients with advanced HER2-negative gastric cancer:a multicenter phase 2 study[J]. Cancer, 2016, 122(9):1434-1443.
[20] Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide:sources, methods and major patterns in GLOBOCAN 2012[J]. Int J Cancer, 2015,136(5):E359-E386.
[21] Chibaudel B, Maindrault-Goebel F, Lledo G, et al. Can chemotherapy be discontinued in unresectable metastatic colorectal cancer? The GERCOR OPTIMOX2 study[J]. J Clin Oncol, 2009, 27(34):5727-5733.
[22] Tournigand C, Cervantes A, Figer A, et al. OPTIMOX1:a randomized study of FOLFOX4 or FOLFOX7 with oxaliplatin in a stop-and-go fashion in advanced colorectal cancer--a GERCOR study[J]. J Clin Oncol, 2006, 24(3):394-400.
[23] Luo HY, Li YH, Wang W, et al. Single-agent capecitabine as maintenance therapy after induction of XELOX(or FOLFOX)in first-line treatment of metastatic colorectal cancer:randomized clinical trial of efficacy and safety[J].Ann Oncol, 2016, 27(6):1074-1081.
[24] Nakayama G, Kodera Y, Yokoyama H, et al. Modified FOLFOX6 with oxaliplatin stop-and-go strategy and oral S-1 maintenance therapy in advanced colorectal cancer:CCOG-0704 study[J]. Int J Clin Oncol, 2011, 16(5):506-511.
[25]董海鹏.替吉奥在晚期转移性结直肠癌维持治疗中的价值[J].中国实用医药, 2017, 12(24):106-107.
[26]孔凡龙.替吉奥维持治疗晚期结直肠癌的临床疗效及安全性评价[J].中国实用医药, 2017, 12(33):90-91.
[27]李绮云,吴兴焕,梁发,等.替吉奥与卡培他滨在晚期结直肠癌一线治疗后维持治疗的临床分析[J].赣南医学院学报, 2017, 37(1):66-69.
[28] Pfeiffer P, Sorbye H, Qvortrup C, et al. Maintenance therapy with cetuximab every second week in the first-line treatment of metastatic colorectal cancer:the NORDIC-7.5 study by the nordic colorectal cancer biomodulation group[J]. Clin Colorectal Cancer, 2015, 14(3):170-176.
[29]陈荣斌,叶汝兴,吴楚海,等.国产抗血管生成药物恩度单药维持治疗晚期结直肠癌综合疗效评价[J].中国医药导报, 2015, 12(14):121-124.
[30] Bendell JC, Joseph M, Barnes K, et al. A phase-2 trial of single agent axitinib as maintenance therapy following first-line treatment with modified FOLFOX/bevacizumab in patients with metastatic colorectal cancer[J]. Cancer Invest, 2017, 35(6):386-392.
[31] Grávalos C, Carrato A, Tobe?a M, et al. A randomized phase II study of axitinib as maintenance therapy after first-line treatment for metastatic colorectal cancer[J].Clin Colorectal Cancer, 2018, 17(2):e323-e329.
[32] Stein A, Schwenke C, Folprecht G, et al. Effect of application and intensity of bevacizumab-based maintenance after induction chemotherapy with bevacizumab for metastatic colorectal cancer:a meta-analysis[J]. Clin Colorectal Cancer, 2016, 15(2):e29-e39.
[33] Hegewisch-Becker S, Graeven U, Lerchenmüller CA, et al. Maintenance strategies after first-line oxaliplatin plus fluoropyrimidine plus bevacizumab for patients with metastatic colorectal cancer(AIO 0207):a randomised, non-inferiority, open-label, phase 3 trial[J]. Lancet Oncol, 2015,16(13):1355-1369.
[34] Goey KKH, Elias SG, Hinke A, et al. Clinicopathological factors influencing outcome in metastatic colorectal cancer patients treated with fluoropyrimidine and bevacizumab maintenance treatment vs observation:an individual patient data meta-analysis of two phase 3 trials[J]. Br J Cancer, 2017, 117(12):1768-1776.
[35] Nakayama G, Ishigure K, Yokoyama H, et al. The efficacy and safety of CapeOX plus bevacizumab therapy followed by capecitabine plus bevacizumab maintenance therapy in patients with metastatic colorectal cancer:a multi-center,single-arm, phase II study(CCOG-0902)[J]. BMC Cancer,2017, 17(1):243.
[36] Zhou M, Fu L, Zhang J. Who will benefit more from maintenance therapy of metastatic colorectal cancer?[J]. Oncotarget, 2017, 9(15):12479-12486.
[37] Tournigand C, Chibaudel B, Samson B, et al. Bevacizumab with or without erlotinib as maintenance therapy in patients with metastatic colorectal cancer(GERCOR DREAM; OPTIMOX3):a randomised, open-label, phase3 trial[J]. Lancet Oncol, 2015, 16(15):1493-1505.
[38] Hagman H, Fr?din JE, Berglund A, et al. A randomized study of KRAS-guided maintenance therapy with bevacizumab, erlotinib or metronomic capecitabine after first-line induction treatment of metastatic colorectal cancer:the Nordic ACT2 trial[J]. Ann Oncol, 2016, 27(1):140-147.
[39] Xu W, Gong Y, Kuang M, et al. Survival benefit and safety of bevacizumab in combination with erlotinib as maintenance therapy in patients with metastatic colorectal cancer:a meta-analysis[J]. Clin Drug Investig, 2017, 37(2):155-165.
[40]卞侠,郭海生,刘曰芬,等.参一胶囊联合卡培他滨维持治疗晚期大肠癌的临床研究[J].癌症进展, 2014, 12(6):589-592.