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中华结直肠疾病电子杂志 ›› 2018, Vol. 07 ›› Issue (02) : 113 -119. doi: 10.3877/cma.j.issn.2095-3224.2018.02.003

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2018年ASCO GI会议结直肠癌诊疗进展
孙婧1, 陈晓锋1, 顾艳宏1,()   
  1. 1. 210029 南京医科大学第一附属医院/江苏省人民医院肿瘤科
  • 收稿日期:2018-03-11 出版日期:2018-04-25
  • 通信作者: 顾艳宏
  • 基金资助:
    国家自然科学基金面上项目(No.81572389); 江苏省333工程(No. BRA 2016517); 江苏省医学重点人才(No. ZDRCA 2016026)

The Progression of colorectal cancer in 2018 ASCO GI

Jing Sun1, Xiaofeng Cheng1, Yanhong Gu1,()   

  1. 1. Department of Oncology, The First Affiliated Hospitl of Nanjing Medical University, Jiangsu People′s Hospital, Nanjing 210029, China
  • Received:2018-03-11 Published:2018-04-25
  • Corresponding author: Yanhong Gu
  • About author:
    Corresponding author: Gu Yanhong, Email:
引用本文:

孙婧, 陈晓锋, 顾艳宏. 2018年ASCO GI会议结直肠癌诊疗进展[J/OL]. 中华结直肠疾病电子杂志, 2018, 07(02): 113-119.

Jing Sun, Xiaofeng Cheng, Yanhong Gu. The Progression of colorectal cancer in 2018 ASCO GI[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2018, 07(02): 113-119.

结直肠癌是高发肿瘤,靶向治疗和免疫治疗的出现使得患者生存较前明显改善。2018 ASCO GI会议在结直肠癌早筛研究中发现外周血循环肿瘤细胞(CTC)有助于筛查早期结直肠癌,息肉甲基化检测可以筛选高复发风险患者。而在靶向治疗方向,研究表明,既往接受氟尿嘧啶/奥沙利铂/伊立替康治疗失败的转移性结直肠癌患者,瑞戈非尼序贯西妥昔单抗(R-C)对比相反治疗(C-R)顺序,R-C模式OS更有优势。免疫治疗领域,nivolumab联合CTLA-4抑制剂ipilimumab的双靶向治疗,在dMMR/MSI-H的晚期患者中获得了更好的疗效,同时安全性可控。

Colorectal cancer (CRC) is a high-incidence tumor worldwide. Targeted therapy and immune therapy significantly improve survival than before. It was reported in 2018 ASCO GI that circulating tumor cells is capable of detecting CRC patients in early stage. CIMP-H associates higher risk of advanced metachronous lesion and genetic profile of polyps could go beyond size and number in the prediction of advanced metachronous lesions. Regarding to targeted therapy, for metastatic colorectal cancer patients previously treated with fluoropyrimidine, oxaliplatin and irinotecan, sequential treatment with regorafenib (R) followed by cetuximab (C) ± irinotecan (R-C arm) is preferred than reverse sequence (C-R arm), especially in OS. In filed of immune therapy, nivolumab+ ipilimumab combination in patients with DNA mismatch repair-deficient/microsatellite instability-high (dMMR/MSI-H) mCRC patients would demonstrate enhanced clinical benefit and manageable safety.

表1 正在进行的涉及结直肠癌免疫治疗的研究汇总
靶点 药物 期别 研究设计 研究编号
抗PD-L1 Atezolizumab(工程化IgG1,无ADCC) I 实体肿瘤 NCT01375842
Ib mCRC(+贝伐珠单抗+cobimetinib) NCT02876224
Ib 实体肿瘤(+贝伐珠单抗± FOLFOX) NCT01633970
II mCRC(+贝伐珠单抗+氟尿嘧啶) NCT02291289
II 化疗耐药MSI-like CRC(+贝伐珠单抗) NCT02982694
II refractory mCRC(卡培他滨+贝伐珠单抗± atezolizumab) NCT02873195
I/II rectal cancer(+术前放化疗) NCT03127007
III MMR-d mCRC(化疗+氟尿嘧啶± atezolizumab) NCT02997228
III MMR-d stage III colon cancer(化疗± atezolizumab) NCT02912559
MEDI4736(修饰IgG1,无ADCC) I Liver mCRC(+tremelimumab+肝切除) NCT02754856
I CRC(+pexidartinib) NCT02777710
I Liver mCRC+MSS(+tremelimumab) NCT03005002
I CRC(+AZD4635) NCT02740985
I 实体瘤(+selumetinib± tremelimumab) NCT02586987
II mCRC NCT02227667
II mCRC(+tremelimumab) NCT03007407
II mCRC(+tremelimumab+放疗或消融) NCT03122509
II CRC(+AZD9150) NCT02983578
II mCRC(+tremelimumab±放疗) NCT02888743
II MSS CRC(+azacitidine) NCT02811497
I/II mCRC(+tremelimumab+FOLFOX) NCT03202758
I/II 实体瘤(+olaparib±cediranib) NCT02484404
I/II CRC(+ONCOS-102) NCT02963831
I/II CRC(+tremelimumab) NCT03206073
靶点 药物 期别 研究设计 研究编号
抗PD-1 Nivolumab(IgG4) I CRC(+epacadostat) NCT02327078
I/II MSI-high mCRC(±伊匹单抗)(CheckMate 142) NCT02060188
I/II 实体肿瘤(+INCB24360) NCT02327078
I/II 实体肿瘤(+化疗) NCT02423954
I/II 实体肿瘤(+varlilumab) NCT02335918
I/II MSS/RAS-mutant NCT03271047
I/II CRC(+binimetinib±ipilimumab) NCT03377361
I/II CRC(+trametinib±ipilimumab) NCT02948348
I/II Rectum cancer(+术后放化疗) NCT03126110
I/II 恶性肿瘤(+IVNCAGNO1876) NCT03241173
II 恶性肿瘤(+IVNCAGNO1949) NCT02060188
II CRC(±其他抗肿瘤药物如ipilimumab,cobimetinib等) NCT03104439
II CRC(+ipilimumab+放疗) NCT03350126
? mCRC(+ipilimumab) NCT03026140
? colon cancer(+ipilimumab+celecoxib) ?
Pembrolizumab(IgG4,人源) I 实体肿瘤(+aflibercept) NCT02298959
I GI肿瘤(+XL888) NCT03095781
I 实体肿瘤(+ICNB039110/INCB050465) NCT02646748
I 实体肿瘤(+AMG386) NCT03239145
I rectal cancer(+TGO2) NCT02933944
I/II GI肿瘤(+mFOLFOX6) NCT02268825
I/II KRAS,BRAF,NRAS WT mCRC(+西妥珠单抗或曲妥珠单抗tratuzumab emtansine) NCT02318901
I/II CRC(+西妥珠单抗) NCT02713373
I/II CRC(+ibrutinib) NCT03332498
I/II mCRC(+BBI608/napabucasin) NCT02851004
I/II CRC(+entinostat) NCT02437136
I/II Colon cancer(+Poly-ICLC) NCT02834052
I/II mCRC(+olaptesed) NCT03168139
I/II 实体肿瘤(+AMG820) NCT02713529
I/II 实体肿瘤(+azacitidine+epacadostat) NCT02959437
I/II 实体肿瘤(+epacadostst+化疗) NCT03085914
I/II 实体肿瘤(+INCB001158) NCT02903914
II mCRC(+放疗或消融) NCT02437071
II mCRC(+mFOLFOX6) NCT02375672
II mCRC(+阿扎胞苷) NCT02260440
II MSI-阳性/阴性CRC NCT01876511
II mCRC(+GVAX+CY) NCT02981524
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