BACKGROUND Colorectal cancer(CRC)is the second leading cause of cancer-related death,lar-gely due to limited treatment options in advanced stages.Genomic alterations in advanced CRC(aCRC)are complex and not fully char...BACKGROUND Colorectal cancer(CRC)is the second leading cause of cancer-related death,lar-gely due to limited treatment options in advanced stages.Genomic alterations in advanced CRC(aCRC)are complex and not fully characterized,with only 30%of patients benefiting from targeted therapies.AIM To investigate the molecular heterogeneity of primary aCRC in order to identify clinically relevant genomic alterations.METHODS We conducted a retrospective molecular analysis of 73 consecutive patients with histologically confirmed primary aCRC(stage pT4a-b).All molecular findings were correlated with available clinicopathological data.In addition,we performed RESULTS Genetic abnormalities identified in primary tumors were most frequently mutations in tumor protein p53(58%of cases),Kirsten rat sarcoma viral oncogene homolog(52%),phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha(25%),B-Raf kinase(11%)and fibroblast growth factor receptor 3(8%),as well as R-spondin 3(RSPO3)fusions(8%).Alterations in the tumor protein p53 and neuroblastoma RAS viral oncogene homolog genes were predominantly observed in tumors from the left colon,whereas B-Raf kinase mutations and RSPO3 fusions were more frequently detected in the right or transverse colon.We also show a strong association between the presence of RSPO3 rearrangements and patients with small tumors,normal carcinoembryonic antigen levels,and microsatellite stable tumors.Furthermore,aCRC patients with protein tyrosine phosphatase receptor type k::RSPO3 fusions exhibited a higher mortality rate.Elevated RSPO3 gene expression levels were also significantly correlated with poorer OS across two large,independent CRC cohorts.CONCLUSION This study identifies a relatively high incidence of RSPO3 rearrangements in aCRC and a strong association with clinical features.Furthermore,we find that RSPO3 fusions are associated with poorer OS.展开更多
BACKGROUND Immune checkpoint inhibitors have demonstrated significant efficacy in colorectal cancer(CRC)patients with microsatellite instability-high or deficient mismatch repair.However,their efficacy as monotherapy ...BACKGROUND Immune checkpoint inhibitors have demonstrated significant efficacy in colorectal cancer(CRC)patients with microsatellite instability-high or deficient mismatch repair.However,their efficacy as monotherapy is limited in microsatellite stable/proficient mismatch repair(MSS/pMMR)subtypes.AIM To provide an evidence-based rationale for optimizing later-line therapeutic strategies in advanced MSS/pMMR CRC.METHODS This study conducted a systematic retrospective analysis to evaluate the efficacy and safety of a triple-combination regimen comprising programmed death 1 inhibitors,fruquintinib and docetaxel administered as third-line therapy in 13 patients with advanced MSS/pMMR CRC.RESULTS Primary endpoints included progression-free survival and disease control rate.Intention-to-treat analysis showed median progression-free survival 7.0 months,median overall survival 18.5 months,disease control rate 61.5%,with manageable toxicity.CONCLUSION Although this is a small-sample retrospective study,it preliminarily validates the synergistic effect of programmed death 1 inhibitors combined with fruquintinib and docetaxel in MSS/pMMR CRC,providing a novel strategy with translational significance for later-line treatment in advanced patients.展开更多
Colorectal cancer(CRC)is one of the most common human malignant diseases and the second leading cause of cancer-related deaths worldwide.The treatment of advanced CRC has improved significantly in recent years.With th...Colorectal cancer(CRC)is one of the most common human malignant diseases and the second leading cause of cancer-related deaths worldwide.The treatment of advanced CRC has improved significantly in recent years.With the emergence of two targeted antibodies,cetuximab(Erbitux),an anti-epidermal growth factor receptor monoclonal antibody and bevacizumab(Avastin),a vascular endothelial growth factor monoclonal antibody,the treatment of metastatic CRC has entered the era of personalized therapy.Predictive and prognostic biomarkers have,and will continue to,facilitate the selection of suitable patients and the personalization of treatment for metastatic CRC(mCRC).In this review,we will focus primarily on the important progresses made in the personalized treatment of mCRC and discuss the potentially novel predictive and prognostic biomarkers for improved selection of patients for anti-cancer treatment in the future.展开更多
Second-line therapy for advanced colorectal cancer is an integral part of the treatment strategy that needs to be set from the beginning for each patient, bearing in mind the expected toxicities of chosen treatments, ...Second-line therapy for advanced colorectal cancer is an integral part of the treatment strategy that needs to be set from the beginning for each patient, bearing in mind the expected toxicities of chosen treatments, the patient's clinical condition, comorbidities, preferences, the aims of the treatment and the molecular status. Furthermore, the distinction between lines of therapy is no longer absolute. The perspective of "continuum of care" includes switching chemotherapy prior to disease progression, maintenance therapy, drug "holidays" if needed, surgical resection of metastases in selected patients, and seems to allow a tailored treatment, in which patients are more likely to benefit from exposure to all active agents, which is known to correlate with overall survival. The scenario of second-line treatment has changed dramatically over the years and could currently benefit from several options including chemotherapy with a single agent or in combination and the addition of molecular-targeted agents developed in the last decade, such as epidermal growth factor receptor antibodies(cetuximab, panitumumab) and vascular endothelial growth factor-targeting agents(bevacizumab, aflibercept), with the possibility of bevacizumab use even beyond first progression. The purpose of this review is to summarize the most important scientific data supporting the use of chemotherapy and the new biologic agents in the second-line setting in advanced colorectal cancer.展开更多
BACKGROUND After the failure of second-line standard therapy,effective treatment options for metastatic colorectal cancer are limited,and the duration of remission cannot meet clinical needs.In addition,associated dru...BACKGROUND After the failure of second-line standard therapy,effective treatment options for metastatic colorectal cancer are limited,and the duration of remission cannot meet clinical needs.In addition,associated drug toxicity may lead to treatment interruption that may affect patient outcomes.Therefore,more safe,effective and convenient treatments are urgently needed.CASE SUMMARY Here,we describe a patient with advanced colorectal cancer with multiple metastases in both lungs.Oxaliplatin combined with 5-fluorouracil or capecitabine was given as the first-line treatment,and bevacizumab combined with irinotecan was given as the second-line treatment after disease progression.However,treatment was interrupted due to recurrent grade 2 nausea and grade 1 diarrhea.He received targeted therapy with fruquintinib starting on August 26,2020 and responded well for 12 mo.After slow progression of the lung metastases,progression-free survival was again achieved over 13.5 mo by continued treatment of fruquintinib in combination with tegafur-gimeracil-oteracil potassium chemotherapy.Overall treatment duration was more than 25.5 mo.The treatments delayed tumor progression,reduced drug side effects,maintained a good quality of life,and further extended overall survival.CONCLUSION This case report detailed preliminary evidence showing that the combination of fruquintinib with tegafur-gimeracil-oteracil potassium chemotherapy double oral therapy may result in longer progression-free survival in patients with advanced colorectal cancer.展开更多
Objective： Although 5-fluarouracil-based chemotherapy has become a standard regimen for treatment of advanced colorectal cancer, the efficacy, as second line therapy, is not high. It is necessary to find a new regime...Objective： Although 5-fluarouracil-based chemotherapy has become a standard regimen for treatment of advanced colorectal cancer, the efficacy, as second line therapy, is not high. It is necessary to find a new regimen as a substitute for these patients. The study was to evaluate the short-time effects and toxicity of combination of HCPT plus L-OHP regimen in treatment of advanced colorectal cancer. Methods： Forty-seven patients with pathological evidence of advanced colorectal cancer were enrolled and were treated with HCPT plus L-OHP regimen for 86 cycles. All patients were treated with L-OHP 130 mg/m^2 day 1 and HCPT 6 mg/m^2day 1-4, the chemotherapy was repeated every 3 weeks as a cycle. The Short-time efficats and side effects were evaluated after 2 cycles for each patient. Results： 38 cases can be evaluated to short-time effects and achieved the overall response rate （CR＋PR） was 36.8%. KPS improved in 20 cases （52.6%）. In the total 86 cycles, the leucopenia occurred in 59 cycles （68.6%）,18 cycles （30.5%） in grade Ⅲ and Ⅳ and the diarrhea occurred in 48 cycles （55.8%）, 18 cycles （37.5%） in grade Ⅲ and Ⅳ. Conclusion： A satisfied response rate was obtained in advanced colorectal cancer patients treated by HCPT plus L-OHP regimen, especially who were the failure of first-line chemotherapy with 5-FU. The limited-dose toxicity was leucopenia and diarrhea.展开更多
Cetuximab is a new medication that has recently been approved for the treatment of advanced colorectal cancer. To date we have had little experience in using this targeted agent. Eleven patients in our hospital with a...Cetuximab is a new medication that has recently been approved for the treatment of advanced colorectal cancer. To date we have had little experience in using this targeted agent. Eleven patients in our hospital with advanced colorectal cancer were treated with cetuximab and chemotherapy. Based on the curative effect of this combination therapy, we have concluded that the following nursing practices make an important contribution to the patients＇ prognosis and wellbeing： to establish a good nurse-patient relationship, to increase patient understanding of the side effects, to standardize the medications, to observe and to deal with the side effects of the medications（for example skin reaction, neutropenia, and diarrhea）, and to provide continuous mental health care support and education.展开更多
BACKGROUND Colorectal cancer(CRC)is a highly prevalent malignancy of the digestive tract worldwide,characterized by a significant morbidity and mortality rate and subtle initial symptoms.Diarrhea,local abdominal pain,...BACKGROUND Colorectal cancer(CRC)is a highly prevalent malignancy of the digestive tract worldwide,characterized by a significant morbidity and mortality rate and subtle initial symptoms.Diarrhea,local abdominal pain,and hematochezia occur with the development of cancer,while systemic symptoms such as anemia and weight loss occur in patients with advanced CRC.Without timely interventions,the disease can have fatal consequences within a short span.The current therapeutic options for colon cancer include olaparib and bevacizumab,which are widely utilized.This study intends to evaluate the clinical efficacy of olaparib combined with bevacizumab in the treatment of advanced CRC,hoping to provide insights into advanced CRC treatment.AIM To investigate the retrospective efficacy of olaparib combined with bevacizumab in the treatment of advanced CRC.METHODS A retrospective analysis was conducted on a cohort of 82 patients with advanced colon cancer who were admitted to the First Affiliated Hospital of the University of South China between January 2018 and October 2019.Among them,43 patients subjected to the classical FOLFOX chemotherapy regimen were selected as the control group,and 39 patients undergoing treatment with olaparib combined with bevacizumab were selected as the observation group.Subsequent to different treatment regimens,the short-term efficacy,time to progression(TTP),and incidence rate of adverse reactions between the two groups were compared.Changes in serum-related indicators[vascular endothelial growth factor(VEGF),matrix metalloprotein-9(MMP-9),cyclooxygenase-2(COX-2)]and tumor markers[human epididymis protein 4(HE4),carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA199)]levels before and after treatment were compared between the two groups at the same time.RESULTS The objective response rate was discovered to be 82.05%,and the disease control rate was 97.44%in the observation group,which were significantly higher than the respective rates of 58.14%and 83.72%in the control group(P<0.05).The median TTP was 24 mo(95%CI:19.987-28.005)in the control group and 37 mo(95%CI:30.854-43.870)in the observation group.The TTP in the observation group was significantly better than that in the control group,and the difference held statistical significance(log-rank test value=5.009,P=0.025).Before treatment,no substantial difference was detected in serum VEGF,MMP-9,and COX-2 levels and tumor markers HE4,CA125,and CA199 levels between the two groups(P>0.05).Following treatment with different regimens,the above indicators in the two groups were remarkably promoted(P<0.05),VEGF,MMP-9,and COX-2 in the observation group were lower than those in the control group(P<0.05),and HE4,CA125,and CA199 levels were also lower than those in the control group(P<0.05).Visà-vis the control group,the total incidence of gastrointestinal reactions,thrombosis,bone marrow suppression,liver and kidney function injury,and other adverse reactions in the observation group was notably lowered,with the difference considered statistically significant(P<0.05).CONCLUSION Olaparib combined with bevacizumab in the treatment of advanced CRC demonstrates a strong clinical effect of delaying disease progression and reducing the serum levels of VEGF,MMP-9,COX-2 and tumor markers HE4,CA125 and CA199.Moreover,given its fewer adverse reactions,it can be regarded as a safe and reliable treatment option.展开更多
Objective:To evaluate the clinical efficacy and safety of Kanglaite injection combined with chemotherapy and chemotherapy alone in the treatment of advanced colorectal cancer.Methods:PubMed,Cochrane library,CNKI,VIP,W...Objective:To evaluate the clinical efficacy and safety of Kanglaite injection combined with chemotherapy and chemotherapy alone in the treatment of advanced colorectal cancer.Methods:PubMed,Cochrane library,CNKI,VIP,Wanfang database were systematically searched by inputting keywords to explore the efficacy of Kanglaite injection combined with chemotherapy in the treatment of advanced colorectal cancer.A random-effects model was selected to evaluate the treatment outcomes.The screening of literature,the extraction of data and the assessment of methodology were independently undertaken by two reviewers.Meta analysis was performed using Revman5.3 software and stata15.0 software.Results:A total of 12 RCTs were included,with 792 cases.Compared with chemotherapy alone,Metaanalysis suggested that Kanglaite injection combined with chemotherapy can improve clinical efficiency(RR=1.45,95%CI:1.21-1.74,P<0.0001)and improve patients'quality of life(RR=1.55,95%CI:1.32-1.82,P<0.00001),improve the patient's immune function(CD3+cells:SWD=1.42,95%CI:1.11-1.73;CD4+/CD8+cell ratio:SWD=0.95,95%CI:0.66-1.25;NK cell activity:SWD=3.24,95%CI:2.81-3.66,P<0.00001);Leukopenia rate(RR=0.63,95%CI:0.54-0.74,P<0.0001),incidence of gastrointestinal adverse reactions(RR=0.56,95%CI:0.48-0.66,P<0.00001),incidence of peripheral neurotoxicity(RR=0.79,95%CI:0.65-0.96,P=0.02)were lower than the chemotherapy alone group,the difference was statistically significant.In improving the hand-foot syndrome and oral mucositis after chemotherapy,there was some difference between the Kanglaite injection combined with chemotherapy group and the chemotherapy alone group,but the difference was not significant.Puber bias detection and sensitivity analysis were performed with clinically effective relative risk(RR)as indicators.The results suggested that the publication bias was not obvious.The results of this study are stable.Conclusion:Compared with chemotherapy alone group in the treatment of advanced colorectal cancer,Kanglaite injection combined with chemotherapy can improve the effective rate,quality of life,immune function of patients and reduce the incidence of leukopenia after chemotherapy,gastrointestinal adverse reactions and peripheral neurotoxicity.展开更多
Colorectal cancer is one of the common malignant tumors in China.It poses a serious threat to the national health of China.For advanced colorectal cancer, the main goal of treatment is to prolong survival and improve ...Colorectal cancer is one of the common malignant tumors in China.It poses a serious threat to the national health of China.For advanced colorectal cancer, the main goal of treatment is to prolong survival and improve quality of life.It complements other advantages, showing good therapeutic results.However, how to grasp the timing of integrated Chinese and Western Medicine for the treatment of advanced colorectal cancer and use the integrated Chinese and Western Medicine treatment methods flexibly contains profound therapeutic art.Prof.YANG Yu-fei is an authoritative expert in the field of integrated Chinese and Western medicine for colorectal cancer.She is good at accurately grasping the timing of treatment of integrated Chinese and Western Medicine, and flexibly adjusts the treatment strategy according to the specific conditions.In this paper, we shared Professor YANG Yu-fei's strategy for treating advanced colorectal cancer with emphasis on integrated Chinese and Western Medicine and attached a typical case, with a view to provide reference for the treatment of advanced colorectal cancer with integrated Chinese and Western Medicine.展开更多
Objective To investigate the clinicopathological characteristics of advanced colorectal cancer which was 30 mm or smaller in diameter. Methods Retrospective analysis documented 80 patients with small advanced colorect...Objective To investigate the clinicopathological characteristics of advanced colorectal cancer which was 30 mm or smaller in diameter. Methods Retrospective analysis documented 80 patients with small advanced colorectal cancer from May 1985 to May 2002. According to the diameter of tumors, all patients were divided into three groups: Group A (10 mm or less), Group B (11-20 mm), Group C (21-30 mm). Considering the number of patients in Group A was smaller, we combined Group A with Group B as Group D. Then various clinicopathological characteristics were compared between Group C and Group D. Results The most common site of small advanced colorectal cancer was sigmoid colon and rectum that accounted for 36.2% and 35.0% of all cases. The average diameter of total tumors was 23.3 mm. Type 2 was the most common macroscopic type (63.7%) and the moderate differentiation was seen in 77.5% of cases. Thirty-eight (47.5%) cases had lymph node metastasis. Three (3.8%) cases had liver metastasis and three (3.8%) cases had peritoneal metastasis. The frequency of lymph node metastasis was found significantly different between Group C and Group D (54.2% vs. 28.6%, P<0.05), as well as between the groups with different depth of invasion (P<0.05). Curability A resection was performed in 69 (86.2%) cases. Conclusions Tumor size and depth of invasion are related to lymph node metastasis in small advanced colorectal cancer. However, the small size of tumor may not always be a.reliable parameter for estimating the risk of lymph node metastasis. Small colorectal cancers also do not always mean the early stage. Surgeons should be aware of the features of small advanced colorectal cancers to select ideal management and perform perfect resection.展开更多
Objective： To observe the efficacy and tolerability of continuously infusing 5-fluorouracil （5-FU） / folic acid combined with oxaliplatin （L-OHP/5-FU/LV regimen） as first line treatment in advanced colorectal can...Objective： To observe the efficacy and tolerability of continuously infusing 5-fluorouracil （5-FU） / folic acid combined with oxaliplatin （L-OHP/5-FU/LV regimen） as first line treatment in advanced colorectal cancer. Methods： 23 patients of advanced colorectal cancer were treated with 5-FU 500 mg/d, civ, d 1-d5, d8-d12, leucovorin 100 mg/d, iv gtt, d1, d8, folic acid tablet 60 mg/d, po, d2-d5, d9-d12, and oxaliplatin 65 mg/（m^2·d）, iv gtt, dl, d8, repeated every 21 days （one cycle）. The effect was evaluated after two cycles. Results： Complete response in 2 cases and partial response in 10 cases were observed with an overall response rate of 47.18%. Adverse effects were mainly grade 1-2, including nausea, vomiting, diarrhea, dental ulcer, peripheral neuritis and myelosuppression. Conclusion： L-OHP/5-FU/LV regimen is an effective and better tolerated alternative treatment in advanced colorectal cancer and yields promising clinical application.展开更多
Objective:To systematically evaluate the efficacy and safety of compound Kushen injection combined with oxaliplatin chemotherapy in the treatment of advanced colorectal cancer.Methods:We searched PubMed,EMbase,the Coc...Objective:To systematically evaluate the efficacy and safety of compound Kushen injection combined with oxaliplatin chemotherapy in the treatment of advanced colorectal cancer.Methods:We searched PubMed,EMbase,the Cochrane Library,CNKI,VIP and Wan Fang database,SinoMed to collect compound Kushen injection combined with chemotherapy oxaliplatin into treatment of advanced colorectal cancer in randomised controlled trials;the databases weresearched from inception to December 2020.Meta-analysis of the included studies was performed using RevMan 5.4.Results:A total of 34 randomized controlled trials involving 2664 patients with colorectal cancer were included.Results of Meta-analysis showed that compound Kushen injection combined with oxaliplatin chemotherapy regimen improved the objective response rate of tumor[RR=1.40,95%CI(1.29,1.51),P<0.00001]and disease control rate[RR=1.12,95%CI(1.08,1,16),P 0.00001]improved the quality of life[RR=1.24,95%CI(1.14,1.36),P<0.00001],and significantly reduced the incidence of leukopenia[RR=0.35,95%CI(0.23,0.52),P<0.00001]and the incidence of diarrhea[RR=0.36,95%CI(0.19,0.70),P=0.003],and improved the immune function of patients(CD3+,CD4+,CD4+/CD8+,NK cell levels).However,compared to the control group,the levels of CD8+cells were decreased in the experimental group.Conclusion:Compound Kushen injection combined with oxaliplatin chemotherapy regimen can significantly improve the clinical efficacy of advanced colorectal cancer patients,improve the quality of life of patients,reduce the occurrence of adverse reactions,and has good efficacy and safety comparison with oxaliplatin chemotherapy regimen alone.展开更多
Concurrent inhibition of angiogenesis and immune checkpoints represents a potent therapeutic approach.We conducted a phase 2,multicenter,basket study to assess the efficacy and safety of combination therapy of famitin...Concurrent inhibition of angiogenesis and immune checkpoints represents a potent therapeutic approach.We conducted a phase 2,multicenter,basket study to assess the efficacy and safety of combination therapy of famitinib(anti-angiogenic agent)plus camrelizumab(PD-1 antagonist)in patients with metastatic solid tumors across 11 cohorts(this study was registered at Clinicaltrials.gov[NCT04346381]).This report focuses on the cohort of patients with metastatic or advanced colorectal cancer.Eligible patients,who had previously received R2 lines of systemic treatments for their metastatic disease,were treated with famitinib(20 mg once daily)in combination with camrelizumab(200 mg intravenously every 3 weeks).The primary endpoint was the objective response rate,with secondary endpoints encompassing progressionfree survival,overall survival,duration of response,safety and exploratory biomarkers.A total of 44 patients were enrolled and treated.With a median follow-up time of 9.46 months(range 2.0-22.5 months),objective responses were observed in 6 patients(13.6%;95%confidence interval[CI],5.2%-27.4%),all of whom had rectal cancer.The median duration of response is 6.2 months(95%CI,2.3-10.6 months).Median progression-free survival was 3.3 months(95%CI,2.1-4.1 months),and median overall survival was 10.9 months(95%CI,7.6-15.2 months).Among the 44 patients,29(65.9%)experienced grade 3 or 4 treatment-related adverse events,predominantly hypertension and proteinuria.In conclusion,the combination of famitinib and camrelizumab demonstrates promising antitumor activity with a manageable safety profile in metastatic colorectal cancer patients.Further research is warranted to confirm and extend these findings.展开更多
This is an investigator-initiated,open-label,single-arm,phase Ⅱ trial that aimed to assess the combination of sintilimab plus anlotinib among patients with treatment-naïve metastatic colorectal cancer(mCRC)(APIC...This is an investigator-initiated,open-label,single-arm,phase Ⅱ trial that aimed to assess the combination of sintilimab plus anlotinib among patients with treatment-naïve metastatic colorectal cancer(mCRC)(APICAL-CRC ClinicalTrials.gov number,NCT04271813).Between June 2020 and September 2023,a total of 30 patients were eventually enrolled and received the study regimen.Among these 30 patients,50%had an Eastern Cooperative Oncology Group(ECOG)score of 0–1,and the other 50%had a score of 2.The objective response rates(ORRs)were 48.3%(95%CI 29.4–67.5)in the efficacy-evaluable cohort and 46.7%(95%CI 28.3–65.7)in the intent-to-treat(ITT)cohort.Twelve patients had stable disease,and the disease control rates(DCRs)were 89.7%(95%CI 72.6–97.8)and 86.7%(95%CI 69.3–96.2)in the efficacy-evaluable and ITT cohorts,respectively.The median progressionfree survival(mPFS)was 8.6 months(95%CI 4.8–11.0),and the median overall survival(mOS)reached 22.9 months(95%CI 13.5–36.3).Treatment-related adverse events(TRAEs)of any grade were reported in 23 patients(76.7%),and grade 3 TRAEs occurred in 4 patients(13.3%).Multivariate Cox regression analysis revealed that the presence of liver metastases was an independent prognostic factor for poor PFS(HR=5.66,95%CI 1.58–20.2)and OS(HR=7.85,95%CI 1.38–44.8),whereas FLT mutation was independently associated with poor OS(HR=12.5,95%CI 1.54–101).This trial demonstrated that sintilimab plus anlotinib exhibited promising antitumor efficacy along with a manageable safety profile among treatment-naïve mCRC patients.展开更多
Objective： To evaluate the efficacy and safety of Oxaliplatin in the patients with colorectal cancer. Methods： In a multicenter randomized control study, a total of 144 patients were divided into four groups： Oxali...Objective： To evaluate the efficacy and safety of Oxaliplatin in the patients with colorectal cancer. Methods： In a multicenter randomized control study, a total of 144 patients were divided into four groups： Oxaliplatin （Haitong） ＋ 5-FU, CF （group A） 41 cases; 5-FU ＋ CF （group B） 41 cases; Oxaliplatin （Haitong） ＋ 5-FU, CF （group C） 31 cases; Oxaliplatin （positive drug） ＋ 5-FU ＋ CF （group D） 31 cases. Oxaliplatin combination regimen： L-OHP 130 mg/m2 i.v. infusion 2 h dl; CF 200 mg/m2 i.v. 2 h d1-d5; 5-FU 300 mg/m2 i.v. infusion 4 h d1-d5 （after CF）. 5-FU ＋ CF combination regimen： CF 200 mg/m^2 i.v. infusion 2 h d1-d5, 5-FU 300 mg/m^2 i.v. infusion 4h d1-d5 （after CF）, the schedule was repeated every 3 weeks. The total cycles were 3. Results： After three circles treatment, overall response rate of 4 groups was 24.4% （group A）, 2.4% （group B）, 25.8% （group C） and 19.4% （group D）, respectively. The response rate was significantly different between group A and group B （P 〈 0.01）, but no significant difference was observed between group C and group D （P 〉 0.05）. Conclusion： The Oxaliplatin （Haitong） for injection combination regimen is effective in the treatment of celorectal cancer.展开更多
Colorectal cancer is the third most common cancer in the world.Surgery is man-datory to treat patients with colorectal cancer.Can colorectal cancer be treated in laparoscopy?Scientific literature has validated the onc...Colorectal cancer is the third most common cancer in the world.Surgery is man-datory to treat patients with colorectal cancer.Can colorectal cancer be treated in laparoscopy?Scientific literature has validated the oncological quality of laparo-scopic approach for the treatment of patients with colorectal cancer.Randomized non-inferiority trials with good remote control have answered positively to this long-debated question.Early as 1994,first publications demonstrated technical feasibility and compliance with oncological imperatives and,as far as short-term outcomes are concerned,there is no difference in terms of mortality and post-operative morbidity between open and minimally invasive surgical approaches,but only longer operating times at the beginning of the experience.Subsequently,from 2007 onwards,long-term results were published that demonstrated the ab-sence of a significant difference regarding overall survival,disease-free survival,quality of life,local and distant recurrence rates between open and minimally in-vasive surgery.In this editorial,we aim to summarize the clinical and technical aspects which,even today,make the use of open surgery relevant and necessary in the treatment of patients with colorectal cancer.展开更多
Advanced digestive tract malignant tumors,represented by advanced colorectal cancer,advanced gastric cancer and advanced esophageal cancer,have insidious onsets and high mortality.Western medicine based on targeted th...Advanced digestive tract malignant tumors,represented by advanced colorectal cancer,advanced gastric cancer and advanced esophageal cancer,have insidious onsets and high mortality.Western medicine based on targeted therapy greatly can improves the benefit and efficacy for patients through population stratification,but its population is limited.Traditional Chinese medicine(TCM)has a long history in treatment of tumors,which is an important part of comprehensive treatment of tumors.Clinical observation has shown that different patients could get different efficacy from TCM treatment.Based on real world registration studies,patients with advanced colorectal cancer,advanced gastric cancer or advanced esophageal cancer who had received TCM treatment were observed and followed,and a TCM dominant population that achieved significant efficacy was screened out to carry out multivariate regression analysis,further explore key factors that affect survival in advanced digestive tract malignant tumors,and establish a prediction model of TCM dominant population.It will provide reference for the follow-up TCM treatment,and provide reference for development of individualized treatment plans,making the TCM treatment for advanced digestive tract malignant tumors more targeted,and helping to improve the benefit rate in TCM.展开更多
文摘BACKGROUND Colorectal cancer(CRC)is the second leading cause of cancer-related death,lar-gely due to limited treatment options in advanced stages.Genomic alterations in advanced CRC(aCRC)are complex and not fully characterized,with only 30%of patients benefiting from targeted therapies.AIM To investigate the molecular heterogeneity of primary aCRC in order to identify clinically relevant genomic alterations.METHODS We conducted a retrospective molecular analysis of 73 consecutive patients with histologically confirmed primary aCRC(stage pT4a-b).All molecular findings were correlated with available clinicopathological data.In addition,we performed RESULTS Genetic abnormalities identified in primary tumors were most frequently mutations in tumor protein p53(58%of cases),Kirsten rat sarcoma viral oncogene homolog(52%),phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha(25%),B-Raf kinase(11%)and fibroblast growth factor receptor 3(8%),as well as R-spondin 3(RSPO3)fusions(8%).Alterations in the tumor protein p53 and neuroblastoma RAS viral oncogene homolog genes were predominantly observed in tumors from the left colon,whereas B-Raf kinase mutations and RSPO3 fusions were more frequently detected in the right or transverse colon.We also show a strong association between the presence of RSPO3 rearrangements and patients with small tumors,normal carcinoembryonic antigen levels,and microsatellite stable tumors.Furthermore,aCRC patients with protein tyrosine phosphatase receptor type k::RSPO3 fusions exhibited a higher mortality rate.Elevated RSPO3 gene expression levels were also significantly correlated with poorer OS across two large,independent CRC cohorts.CONCLUSION This study identifies a relatively high incidence of RSPO3 rearrangements in aCRC and a strong association with clinical features.Furthermore,we find that RSPO3 fusions are associated with poorer OS.
文摘BACKGROUND Immune checkpoint inhibitors have demonstrated significant efficacy in colorectal cancer(CRC)patients with microsatellite instability-high or deficient mismatch repair.However,their efficacy as monotherapy is limited in microsatellite stable/proficient mismatch repair(MSS/pMMR)subtypes.AIM To provide an evidence-based rationale for optimizing later-line therapeutic strategies in advanced MSS/pMMR CRC.METHODS This study conducted a systematic retrospective analysis to evaluate the efficacy and safety of a triple-combination regimen comprising programmed death 1 inhibitors,fruquintinib and docetaxel administered as third-line therapy in 13 patients with advanced MSS/pMMR CRC.RESULTS Primary endpoints included progression-free survival and disease control rate.Intention-to-treat analysis showed median progression-free survival 7.0 months,median overall survival 18.5 months,disease control rate 61.5%,with manageable toxicity.CONCLUSION Although this is a small-sample retrospective study,it preliminarily validates the synergistic effect of programmed death 1 inhibitors combined with fruquintinib and docetaxel in MSS/pMMR CRC,providing a novel strategy with translational significance for later-line treatment in advanced patients.
基金Supported by National High-Tech R and D Program of China,863 Program,No.2012AA02A506The Science and Technology Department of Guangdong Province,China,No.2012B031800088
文摘Colorectal cancer(CRC)is one of the most common human malignant diseases and the second leading cause of cancer-related deaths worldwide.The treatment of advanced CRC has improved significantly in recent years.With the emergence of two targeted antibodies,cetuximab(Erbitux),an anti-epidermal growth factor receptor monoclonal antibody and bevacizumab(Avastin),a vascular endothelial growth factor monoclonal antibody,the treatment of metastatic CRC has entered the era of personalized therapy.Predictive and prognostic biomarkers have,and will continue to,facilitate the selection of suitable patients and the personalization of treatment for metastatic CRC(mCRC).In this review,we will focus primarily on the important progresses made in the personalized treatment of mCRC and discuss the potentially novel predictive and prognostic biomarkers for improved selection of patients for anti-cancer treatment in the future.
文摘Second-line therapy for advanced colorectal cancer is an integral part of the treatment strategy that needs to be set from the beginning for each patient, bearing in mind the expected toxicities of chosen treatments, the patient's clinical condition, comorbidities, preferences, the aims of the treatment and the molecular status. Furthermore, the distinction between lines of therapy is no longer absolute. The perspective of "continuum of care" includes switching chemotherapy prior to disease progression, maintenance therapy, drug "holidays" if needed, surgical resection of metastases in selected patients, and seems to allow a tailored treatment, in which patients are more likely to benefit from exposure to all active agents, which is known to correlate with overall survival. The scenario of second-line treatment has changed dramatically over the years and could currently benefit from several options including chemotherapy with a single agent or in combination and the addition of molecular-targeted agents developed in the last decade, such as epidermal growth factor receptor antibodies(cetuximab, panitumumab) and vascular endothelial growth factor-targeting agents(bevacizumab, aflibercept), with the possibility of bevacizumab use even beyond first progression. The purpose of this review is to summarize the most important scientific data supporting the use of chemotherapy and the new biologic agents in the second-line setting in advanced colorectal cancer.
文摘BACKGROUND After the failure of second-line standard therapy,effective treatment options for metastatic colorectal cancer are limited,and the duration of remission cannot meet clinical needs.In addition,associated drug toxicity may lead to treatment interruption that may affect patient outcomes.Therefore,more safe,effective and convenient treatments are urgently needed.CASE SUMMARY Here,we describe a patient with advanced colorectal cancer with multiple metastases in both lungs.Oxaliplatin combined with 5-fluorouracil or capecitabine was given as the first-line treatment,and bevacizumab combined with irinotecan was given as the second-line treatment after disease progression.However,treatment was interrupted due to recurrent grade 2 nausea and grade 1 diarrhea.He received targeted therapy with fruquintinib starting on August 26,2020 and responded well for 12 mo.After slow progression of the lung metastases,progression-free survival was again achieved over 13.5 mo by continued treatment of fruquintinib in combination with tegafur-gimeracil-oteracil potassium chemotherapy.Overall treatment duration was more than 25.5 mo.The treatments delayed tumor progression,reduced drug side effects,maintained a good quality of life,and further extended overall survival.CONCLUSION This case report detailed preliminary evidence showing that the combination of fruquintinib with tegafur-gimeracil-oteracil potassium chemotherapy double oral therapy may result in longer progression-free survival in patients with advanced colorectal cancer.
文摘Objective： Although 5-fluarouracil-based chemotherapy has become a standard regimen for treatment of advanced colorectal cancer, the efficacy, as second line therapy, is not high. It is necessary to find a new regimen as a substitute for these patients. The study was to evaluate the short-time effects and toxicity of combination of HCPT plus L-OHP regimen in treatment of advanced colorectal cancer. Methods： Forty-seven patients with pathological evidence of advanced colorectal cancer were enrolled and were treated with HCPT plus L-OHP regimen for 86 cycles. All patients were treated with L-OHP 130 mg/m^2 day 1 and HCPT 6 mg/m^2day 1-4, the chemotherapy was repeated every 3 weeks as a cycle. The Short-time efficats and side effects were evaluated after 2 cycles for each patient. Results： 38 cases can be evaluated to short-time effects and achieved the overall response rate （CR＋PR） was 36.8%. KPS improved in 20 cases （52.6%）. In the total 86 cycles, the leucopenia occurred in 59 cycles （68.6%）,18 cycles （30.5%） in grade Ⅲ and Ⅳ and the diarrhea occurred in 48 cycles （55.8%）, 18 cycles （37.5%） in grade Ⅲ and Ⅳ. Conclusion： A satisfied response rate was obtained in advanced colorectal cancer patients treated by HCPT plus L-OHP regimen, especially who were the failure of first-line chemotherapy with 5-FU. The limited-dose toxicity was leucopenia and diarrhea.
文摘Cetuximab is a new medication that has recently been approved for the treatment of advanced colorectal cancer. To date we have had little experience in using this targeted agent. Eleven patients in our hospital with advanced colorectal cancer were treated with cetuximab and chemotherapy. Based on the curative effect of this combination therapy, we have concluded that the following nursing practices make an important contribution to the patients＇ prognosis and wellbeing： to establish a good nurse-patient relationship, to increase patient understanding of the side effects, to standardize the medications, to observe and to deal with the side effects of the medications（for example skin reaction, neutropenia, and diarrhea）, and to provide continuous mental health care support and education.
文摘BACKGROUND Colorectal cancer(CRC)is a highly prevalent malignancy of the digestive tract worldwide,characterized by a significant morbidity and mortality rate and subtle initial symptoms.Diarrhea,local abdominal pain,and hematochezia occur with the development of cancer,while systemic symptoms such as anemia and weight loss occur in patients with advanced CRC.Without timely interventions,the disease can have fatal consequences within a short span.The current therapeutic options for colon cancer include olaparib and bevacizumab,which are widely utilized.This study intends to evaluate the clinical efficacy of olaparib combined with bevacizumab in the treatment of advanced CRC,hoping to provide insights into advanced CRC treatment.AIM To investigate the retrospective efficacy of olaparib combined with bevacizumab in the treatment of advanced CRC.METHODS A retrospective analysis was conducted on a cohort of 82 patients with advanced colon cancer who were admitted to the First Affiliated Hospital of the University of South China between January 2018 and October 2019.Among them,43 patients subjected to the classical FOLFOX chemotherapy regimen were selected as the control group,and 39 patients undergoing treatment with olaparib combined with bevacizumab were selected as the observation group.Subsequent to different treatment regimens,the short-term efficacy,time to progression(TTP),and incidence rate of adverse reactions between the two groups were compared.Changes in serum-related indicators[vascular endothelial growth factor(VEGF),matrix metalloprotein-9(MMP-9),cyclooxygenase-2(COX-2)]and tumor markers[human epididymis protein 4(HE4),carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA199)]levels before and after treatment were compared between the two groups at the same time.RESULTS The objective response rate was discovered to be 82.05%,and the disease control rate was 97.44%in the observation group,which were significantly higher than the respective rates of 58.14%and 83.72%in the control group(P<0.05).The median TTP was 24 mo(95%CI:19.987-28.005)in the control group and 37 mo(95%CI:30.854-43.870)in the observation group.The TTP in the observation group was significantly better than that in the control group,and the difference held statistical significance(log-rank test value=5.009,P=0.025).Before treatment,no substantial difference was detected in serum VEGF,MMP-9,and COX-2 levels and tumor markers HE4,CA125,and CA199 levels between the two groups(P>0.05).Following treatment with different regimens,the above indicators in the two groups were remarkably promoted(P<0.05),VEGF,MMP-9,and COX-2 in the observation group were lower than those in the control group(P<0.05),and HE4,CA125,and CA199 levels were also lower than those in the control group(P<0.05).Visà-vis the control group,the total incidence of gastrointestinal reactions,thrombosis,bone marrow suppression,liver and kidney function injury,and other adverse reactions in the observation group was notably lowered,with the difference considered statistically significant(P<0.05).CONCLUSION Olaparib combined with bevacizumab in the treatment of advanced CRC demonstrates a strong clinical effect of delaying disease progression and reducing the serum levels of VEGF,MMP-9,COX-2 and tumor markers HE4,CA125 and CA199.Moreover,given its fewer adverse reactions,it can be regarded as a safe and reliable treatment option.
基金This work was financially sponsored by NSFC regional science foundation project(No.:81673862,No.:81660833,No.:81760814)Department of education of Guizhou Province(No.:Qian Jiao Yan He GZS Zi[2016]08)+1 种基金Department of science and technology of Guizhou Province(No.:Qian Ke He talent(2016)4032,Organization Department of Guizhou Province:Qian Ren Ling Fa[2018]No.3Guizhou graduate workstation plan(Department of Education):Qian Jiao Yan He jysz Zi[2014]018.
文摘Objective:To evaluate the clinical efficacy and safety of Kanglaite injection combined with chemotherapy and chemotherapy alone in the treatment of advanced colorectal cancer.Methods:PubMed,Cochrane library,CNKI,VIP,Wanfang database were systematically searched by inputting keywords to explore the efficacy of Kanglaite injection combined with chemotherapy in the treatment of advanced colorectal cancer.A random-effects model was selected to evaluate the treatment outcomes.The screening of literature,the extraction of data and the assessment of methodology were independently undertaken by two reviewers.Meta analysis was performed using Revman5.3 software and stata15.0 software.Results:A total of 12 RCTs were included,with 792 cases.Compared with chemotherapy alone,Metaanalysis suggested that Kanglaite injection combined with chemotherapy can improve clinical efficiency(RR=1.45,95%CI:1.21-1.74,P<0.0001)and improve patients'quality of life(RR=1.55,95%CI:1.32-1.82,P<0.00001),improve the patient's immune function(CD3+cells:SWD=1.42,95%CI:1.11-1.73;CD4+/CD8+cell ratio:SWD=0.95,95%CI:0.66-1.25;NK cell activity:SWD=3.24,95%CI:2.81-3.66,P<0.00001);Leukopenia rate(RR=0.63,95%CI:0.54-0.74,P<0.0001),incidence of gastrointestinal adverse reactions(RR=0.56,95%CI:0.48-0.66,P<0.00001),incidence of peripheral neurotoxicity(RR=0.79,95%CI:0.65-0.96,P=0.02)were lower than the chemotherapy alone group,the difference was statistically significant.In improving the hand-foot syndrome and oral mucositis after chemotherapy,there was some difference between the Kanglaite injection combined with chemotherapy group and the chemotherapy alone group,but the difference was not significant.Puber bias detection and sensitivity analysis were performed with clinically effective relative risk(RR)as indicators.The results suggested that the publication bias was not obvious.The results of this study are stable.Conclusion:Compared with chemotherapy alone group in the treatment of advanced colorectal cancer,Kanglaite injection combined with chemotherapy can improve the effective rate,quality of life,immune function of patients and reduce the incidence of leukopenia after chemotherapy,gastrointestinal adverse reactions and peripheral neurotoxicity.
基金the National Natural Science Foundation of China(81573958):The intervention and mechanism of the ear acupuncture on the appetite of patients with advanced cancer,person in charge:HE BinNational Natural Science Foundation of China(81573781):Study on the effect mechanism of Chinese medicine Fuzheng Quxie theory on advanced colorectal cancer based on the TOLL-like receptor family to regulate intestinal flora and host immune balance regulation,person in charge:YANG Yu-fei
文摘Colorectal cancer is one of the common malignant tumors in China.It poses a serious threat to the national health of China.For advanced colorectal cancer, the main goal of treatment is to prolong survival and improve quality of life.It complements other advantages, showing good therapeutic results.However, how to grasp the timing of integrated Chinese and Western Medicine for the treatment of advanced colorectal cancer and use the integrated Chinese and Western Medicine treatment methods flexibly contains profound therapeutic art.Prof.YANG Yu-fei is an authoritative expert in the field of integrated Chinese and Western medicine for colorectal cancer.She is good at accurately grasping the timing of treatment of integrated Chinese and Western Medicine, and flexibly adjusts the treatment strategy according to the specific conditions.In this paper, we shared Professor YANG Yu-fei's strategy for treating advanced colorectal cancer with emphasis on integrated Chinese and Western Medicine and attached a typical case, with a view to provide reference for the treatment of advanced colorectal cancer with integrated Chinese and Western Medicine.
文摘Objective To investigate the clinicopathological characteristics of advanced colorectal cancer which was 30 mm or smaller in diameter. Methods Retrospective analysis documented 80 patients with small advanced colorectal cancer from May 1985 to May 2002. According to the diameter of tumors, all patients were divided into three groups: Group A (10 mm or less), Group B (11-20 mm), Group C (21-30 mm). Considering the number of patients in Group A was smaller, we combined Group A with Group B as Group D. Then various clinicopathological characteristics were compared between Group C and Group D. Results The most common site of small advanced colorectal cancer was sigmoid colon and rectum that accounted for 36.2% and 35.0% of all cases. The average diameter of total tumors was 23.3 mm. Type 2 was the most common macroscopic type (63.7%) and the moderate differentiation was seen in 77.5% of cases. Thirty-eight (47.5%) cases had lymph node metastasis. Three (3.8%) cases had liver metastasis and three (3.8%) cases had peritoneal metastasis. The frequency of lymph node metastasis was found significantly different between Group C and Group D (54.2% vs. 28.6%, P<0.05), as well as between the groups with different depth of invasion (P<0.05). Curability A resection was performed in 69 (86.2%) cases. Conclusions Tumor size and depth of invasion are related to lymph node metastasis in small advanced colorectal cancer. However, the small size of tumor may not always be a.reliable parameter for estimating the risk of lymph node metastasis. Small colorectal cancers also do not always mean the early stage. Surgeons should be aware of the features of small advanced colorectal cancers to select ideal management and perform perfect resection.
文摘Objective： To observe the efficacy and tolerability of continuously infusing 5-fluorouracil （5-FU） / folic acid combined with oxaliplatin （L-OHP/5-FU/LV regimen） as first line treatment in advanced colorectal cancer. Methods： 23 patients of advanced colorectal cancer were treated with 5-FU 500 mg/d, civ, d 1-d5, d8-d12, leucovorin 100 mg/d, iv gtt, d1, d8, folic acid tablet 60 mg/d, po, d2-d5, d9-d12, and oxaliplatin 65 mg/（m^2·d）, iv gtt, dl, d8, repeated every 21 days （one cycle）. The effect was evaluated after two cycles. Results： Complete response in 2 cases and partial response in 10 cases were observed with an overall response rate of 47.18%. Adverse effects were mainly grade 1-2, including nausea, vomiting, diarrhea, dental ulcer, peripheral neuritis and myelosuppression. Conclusion： L-OHP/5-FU/LV regimen is an effective and better tolerated alternative treatment in advanced colorectal cancer and yields promising clinical application.
基金National Natural Science Foundation of China(No.8207142125)National Clinical Base of Traditional Chinese Medicine Business Construction Research Project(No.2015ZSB01)Evidence-based Medicine Program of China Academy of Chinese Medical Sciences(No.K-858)。
文摘Objective:To systematically evaluate the efficacy and safety of compound Kushen injection combined with oxaliplatin chemotherapy in the treatment of advanced colorectal cancer.Methods:We searched PubMed,EMbase,the Cochrane Library,CNKI,VIP and Wan Fang database,SinoMed to collect compound Kushen injection combined with chemotherapy oxaliplatin into treatment of advanced colorectal cancer in randomised controlled trials;the databases weresearched from inception to December 2020.Meta-analysis of the included studies was performed using RevMan 5.4.Results:A total of 34 randomized controlled trials involving 2664 patients with colorectal cancer were included.Results of Meta-analysis showed that compound Kushen injection combined with oxaliplatin chemotherapy regimen improved the objective response rate of tumor[RR=1.40,95%CI(1.29,1.51),P<0.00001]and disease control rate[RR=1.12,95%CI(1.08,1,16),P 0.00001]improved the quality of life[RR=1.24,95%CI(1.14,1.36),P<0.00001],and significantly reduced the incidence of leukopenia[RR=0.35,95%CI(0.23,0.52),P<0.00001]and the incidence of diarrhea[RR=0.36,95%CI(0.19,0.70),P=0.003],and improved the immune function of patients(CD3+,CD4+,CD4+/CD8+,NK cell levels).However,compared to the control group,the levels of CD8+cells were decreased in the experimental group.Conclusion:Compound Kushen injection combined with oxaliplatin chemotherapy regimen can significantly improve the clinical efficacy of advanced colorectal cancer patients,improve the quality of life of patients,reduce the occurrence of adverse reactions,and has good efficacy and safety comparison with oxaliplatin chemotherapy regimen alone.
基金supported by Jiangsu Hengrui Pharmaceuticals Co.,Ltd.,National Natural Science Foundation of China(82373402,82272775)Shanghai Shen-kang Hospital Development Center(SHDC2022CRT001)+1 种基金Shanghai Rising-Star Program(21QA1401600)the Cancer Center,Zhongshan Hospital(2023XKPT19-RC1).
文摘Concurrent inhibition of angiogenesis and immune checkpoints represents a potent therapeutic approach.We conducted a phase 2,multicenter,basket study to assess the efficacy and safety of combination therapy of famitinib(anti-angiogenic agent)plus camrelizumab(PD-1 antagonist)in patients with metastatic solid tumors across 11 cohorts(this study was registered at Clinicaltrials.gov[NCT04346381]).This report focuses on the cohort of patients with metastatic or advanced colorectal cancer.Eligible patients,who had previously received R2 lines of systemic treatments for their metastatic disease,were treated with famitinib(20 mg once daily)in combination with camrelizumab(200 mg intravenously every 3 weeks).The primary endpoint was the objective response rate,with secondary endpoints encompassing progressionfree survival,overall survival,duration of response,safety and exploratory biomarkers.A total of 44 patients were enrolled and treated.With a median follow-up time of 9.46 months(range 2.0-22.5 months),objective responses were observed in 6 patients(13.6%;95%confidence interval[CI],5.2%-27.4%),all of whom had rectal cancer.The median duration of response is 6.2 months(95%CI,2.3-10.6 months).Median progression-free survival was 3.3 months(95%CI,2.1-4.1 months),and median overall survival was 10.9 months(95%CI,7.6-15.2 months).Among the 44 patients,29(65.9%)experienced grade 3 or 4 treatment-related adverse events,predominantly hypertension and proteinuria.In conclusion,the combination of famitinib and camrelizumab demonstrates promising antitumor activity with a manageable safety profile in metastatic colorectal cancer patients.Further research is warranted to confirm and extend these findings.
基金supported by Chinese National Natural Science Funding[grant number 82172710,2021]the Shanghai Public Health Outstanding Academic Leader Program(GWVI-11.2-XD22,grant to Y.S.Z.)+4 种基金the Shanghai Oriental Talents Program(grant to Y.S.Z.)the Shanghai Municipal Health Commission Health Industry Clinical Research Project(202240277,grant to Z.W.20224Y0077,grant to B.D.Q.)the Innovation Clinical Research Project of Shanghai Changzheng Hospital[grant number 2020YLCYJ-Z03,2020grant number 2023YJBF-FH05,2023].
文摘This is an investigator-initiated,open-label,single-arm,phase Ⅱ trial that aimed to assess the combination of sintilimab plus anlotinib among patients with treatment-naïve metastatic colorectal cancer(mCRC)(APICAL-CRC ClinicalTrials.gov number,NCT04271813).Between June 2020 and September 2023,a total of 30 patients were eventually enrolled and received the study regimen.Among these 30 patients,50%had an Eastern Cooperative Oncology Group(ECOG)score of 0–1,and the other 50%had a score of 2.The objective response rates(ORRs)were 48.3%(95%CI 29.4–67.5)in the efficacy-evaluable cohort and 46.7%(95%CI 28.3–65.7)in the intent-to-treat(ITT)cohort.Twelve patients had stable disease,and the disease control rates(DCRs)were 89.7%(95%CI 72.6–97.8)and 86.7%(95%CI 69.3–96.2)in the efficacy-evaluable and ITT cohorts,respectively.The median progressionfree survival(mPFS)was 8.6 months(95%CI 4.8–11.0),and the median overall survival(mOS)reached 22.9 months(95%CI 13.5–36.3).Treatment-related adverse events(TRAEs)of any grade were reported in 23 patients(76.7%),and grade 3 TRAEs occurred in 4 patients(13.3%).Multivariate Cox regression analysis revealed that the presence of liver metastases was an independent prognostic factor for poor PFS(HR=5.66,95%CI 1.58–20.2)and OS(HR=7.85,95%CI 1.38–44.8),whereas FLT mutation was independently associated with poor OS(HR=12.5,95%CI 1.54–101).This trial demonstrated that sintilimab plus anlotinib exhibited promising antitumor efficacy along with a manageable safety profile among treatment-naïve mCRC patients.
文摘Objective： To evaluate the efficacy and safety of Oxaliplatin in the patients with colorectal cancer. Methods： In a multicenter randomized control study, a total of 144 patients were divided into four groups： Oxaliplatin （Haitong） ＋ 5-FU, CF （group A） 41 cases; 5-FU ＋ CF （group B） 41 cases; Oxaliplatin （Haitong） ＋ 5-FU, CF （group C） 31 cases; Oxaliplatin （positive drug） ＋ 5-FU ＋ CF （group D） 31 cases. Oxaliplatin combination regimen： L-OHP 130 mg/m2 i.v. infusion 2 h dl; CF 200 mg/m2 i.v. 2 h d1-d5; 5-FU 300 mg/m2 i.v. infusion 4 h d1-d5 （after CF）. 5-FU ＋ CF combination regimen： CF 200 mg/m^2 i.v. infusion 2 h d1-d5, 5-FU 300 mg/m^2 i.v. infusion 4h d1-d5 （after CF）, the schedule was repeated every 3 weeks. The total cycles were 3. Results： After three circles treatment, overall response rate of 4 groups was 24.4% （group A）, 2.4% （group B）, 25.8% （group C） and 19.4% （group D）, respectively. The response rate was significantly different between group A and group B （P 〈 0.01）, but no significant difference was observed between group C and group D （P 〉 0.05）. Conclusion： The Oxaliplatin （Haitong） for injection combination regimen is effective in the treatment of celorectal cancer.
文摘Colorectal cancer is the third most common cancer in the world.Surgery is man-datory to treat patients with colorectal cancer.Can colorectal cancer be treated in laparoscopy?Scientific literature has validated the oncological quality of laparo-scopic approach for the treatment of patients with colorectal cancer.Randomized non-inferiority trials with good remote control have answered positively to this long-debated question.Early as 1994,first publications demonstrated technical feasibility and compliance with oncological imperatives and,as far as short-term outcomes are concerned,there is no difference in terms of mortality and post-operative morbidity between open and minimally invasive surgical approaches,but only longer operating times at the beginning of the experience.Subsequently,from 2007 onwards,long-term results were published that demonstrated the ab-sence of a significant difference regarding overall survival,disease-free survival,quality of life,local and distant recurrence rates between open and minimally in-vasive surgery.In this editorial,we aim to summarize the clinical and technical aspects which,even today,make the use of open surgery relevant and necessary in the treatment of patients with colorectal cancer.
基金Special Projects of Capital Scientific Research on Health Development(No.2016-1-4171)Projects on"Millions"of Talents for Inheritance and Innovation of Traditional Chinese Medicine of National Administration of Traditional Chinese Medicine(Qihuang Projects)。
文摘Advanced digestive tract malignant tumors,represented by advanced colorectal cancer,advanced gastric cancer and advanced esophageal cancer,have insidious onsets and high mortality.Western medicine based on targeted therapy greatly can improves the benefit and efficacy for patients through population stratification,but its population is limited.Traditional Chinese medicine(TCM)has a long history in treatment of tumors,which is an important part of comprehensive treatment of tumors.Clinical observation has shown that different patients could get different efficacy from TCM treatment.Based on real world registration studies,patients with advanced colorectal cancer,advanced gastric cancer or advanced esophageal cancer who had received TCM treatment were observed and followed,and a TCM dominant population that achieved significant efficacy was screened out to carry out multivariate regression analysis,further explore key factors that affect survival in advanced digestive tract malignant tumors,and establish a prediction model of TCM dominant population.It will provide reference for the follow-up TCM treatment,and provide reference for development of individualized treatment plans,making the TCM treatment for advanced digestive tract malignant tumors more targeted,and helping to improve the benefit rate in TCM.
