培训课件--消化道肿瘤常用化疗方案.pptVIP

Improving survival from 9 to 20. Workhorse is the 5-FU. Studies undder-score the use of CI-5FU as the infusional partner. First antiangiogenic agent Avastin added to survival. FOLFOX4 IROX IFL in response rate, TTP and “OS”. (N9741) FOLFIRI (17 months) CI 5-FU/LV; AIO+IRI (20 months) AIO 5FU/LV in RR, TTP but not “OS”. Avastin + IFL (20 months) is associated with IFL toxicities as well as HTN, proteinuria and perforation. We do not yet know FOLFIRI or FOLFOX plus Avastin? The new bench mark for median survival for metastatic CRC is 20 months (IFL+Avastin, AIO+IRI, FOLFOX4, FOLIRI) All studies underscored the importance of infusional 5-FU exposure to All active agents (5FU, IRI, LHOP). Addition of Avastin, C225 may further impact on survival Choice of frontline therapy should depend on preference on toxicities: CPT11 for diarrhea (30%) and oxaliplatin for neuropathy (18%). 在静滴方案基础上有衍生了一系列开普拓联合5Fu的持续静滴方案统称FOLFIRI方案。 无论是当一线或二线方案)的病人有明显延长之中位生存期 Two international, open-label, randomised, phase III trials have compared oral Xeloda with i.v. bolus 5-FU/LV (Mayo Clinic regimen). One trial was conducted in the Americas [1] and the other was performed in Europe, the Middle East and Australasia [2]. The two trials were identical in design, selection criteria, conduct and monitoring and it was predefined to pool the data from both to obtain information on a large patient population. Therefore, a prospectively designed, integrated analysis of data from the two studies was performed [3]: The primary objective of the studies was to demonstrate that as first-line therapy for metastatic CRC oral Xeloda achieves a response rate at least equivalent to that achieved with i.v. 5-FU/LV. Secondary objectives included comparison of efficacy profiles, including time to disease progression (TTP) and overall survival, safety profiles and medical resource use. All patients had metastatic and/or advanced CRC not previously treated with cytotoxic chemotherapy, except (neo)adj