Abstract：
BACKGROUND: Patients with V-Raf murine sarcoma viral oncogene homolog B1 (BRAF) V600E-mutated advanced colorectal cancer (CRC) have a poor prognosis, and treatment options that can improve outcome are still under investigation. The purpose of this study was to discuss the differences of overall survival (OS) and progression-free survival (PFS) between patients with BRAF V600E-mutated advanced CRC who were treated with chemotherapy alone and chemotherapy combined with targeted therapy in advanced first-line therapy.
METHODS: Grouping of 61 patients according to first-line treatment regimen (chemotherapy alone/chemotherapy combined with bevacizumab). Kaplan-Meier method and log-rank test were used to compare OS and PFS. Cox proportional hazards regression model was used to measure the risk of first-line medication therapies while correcting for confounding factors that may affect PFS and OS.
RESULTS: There was no significant difference in OS between patients treated with chemotherapy alone and those treated with chemotherapy combined with bevacizumab (P = 0.93; HR, 1.027; 95% CI, 0.555-1.901). Likewise, there was no significant difference in PFS between the two groups (P = 0.29; HR, 0.734; 95% CI, 0.413-1.304). Subgroup analysis showed that OS and PFS of different treatment regimens were not significantly different among subgroups. Multivariate analysis suggested that surgical treatment of primary tumor (P = 0.001; HR, 0.326; 95% CI, 0.169-0.631) and presence of liver metastasis (P = 0.009; HR, 2.399; 95% CI, 1.242-4.635) may serve as independent prognostic indicators in patients with BRAF-mutated advanced CRC. Surgical treatment of the primary tumor (P = 0.041; HR, 0.523; 95% CI, 0.280-0.974) was significantly associated with PFS too.
CONCLUSIONS: For patients with BRAF V600E-mutated advanced CRC, chemotherapy alone did not differ significantly in OS and PFS compared with chemotherapy + bevacizumab for advanced first-line therapy. Chemotherapy combined with targeted therapy did not render a survival benefit to these patients, demonstrating that the importance of developing new treatment options for this population.
METHODS: Grouping of 61 patients according to first-line treatment regimen (chemotherapy alone/chemotherapy combined with bevacizumab). Kaplan-Meier method and log-rank test were used to compare OS and PFS. Cox proportional hazards regression model was used to measure the risk of first-line medication therapies while correcting for confounding factors that may affect PFS and OS.
RESULTS: There was no significant difference in OS between patients treated with chemotherapy alone and those treated with chemotherapy combined with bevacizumab (P = 0.93; HR, 1.027; 95% CI, 0.555-1.901). Likewise, there was no significant difference in PFS between the two groups (P = 0.29; HR, 0.734; 95% CI, 0.413-1.304). Subgroup analysis showed that OS and PFS of different treatment regimens were not significantly different among subgroups. Multivariate analysis suggested that surgical treatment of primary tumor (P = 0.001; HR, 0.326; 95% CI, 0.169-0.631) and presence of liver metastasis (P = 0.009; HR, 2.399; 95% CI, 1.242-4.635) may serve as independent prognostic indicators in patients with BRAF-mutated advanced CRC. Surgical treatment of the primary tumor (P = 0.041; HR, 0.523; 95% CI, 0.280-0.974) was significantly associated with PFS too.
CONCLUSIONS: For patients with BRAF V600E-mutated advanced CRC, chemotherapy alone did not differ significantly in OS and PFS compared with chemotherapy + bevacizumab for advanced first-line therapy. Chemotherapy combined with targeted therapy did not render a survival benefit to these patients, demonstrating that the importance of developing new treatment options for this population.
摘要：
背景：V-Raf鼠肉瘤病毒癌基因同源物B1（BRAF）V600E突变的晚期结直肠癌（CRC）患者预后不良，可以改善结果的治疗方案仍在研究中。目的探讨BRAFV600E突变的晚期CRC患者在晚期一线治疗中单纯化疗和化疗联合靶向治疗的总生存期(OS)和无进展生存期(PFS)的差异。
方法：按照一线治疗方案（单纯化疗/化疗联合贝伐单抗）对61例患者进行分组。采用Kaplan-Meier法和对数秩检验比较OS和PFS。Cox比例风险回归模型用于测量一线药物治疗的风险，同时校正可能影响PFS和OS的混杂因素。
结果：单纯化疗与化疗联合贝伐单抗治疗患者的OS无显著差异（P=0.93；HR，1.027；95%CI，0.555-1.901）。同样，两组间PFS无显著差异(P=0.29;HR,0.734；95%CI，0.413-1.304）。亚组分析显示，不同治疗方案的OS和PFS在各亚组之间差异无统计学意义。多因素分析提示原发肿瘤手术治疗(P=0.001;HR,0.326；95%CI，0.169-0.631）和存在肝转移（P=0.009；HR，2.399；95%CI，1.242-4.635）可作为BRAF突变的晚期CRC患者的独立预后指标。原发性肿瘤的手术治疗（P=0.041；HR，0.523；95%CI，0.280-0.974)也与PFS显著相关。
结论：对于BRAFV600E突变的晚期CRC患者，与晚期一线治疗的化疗+贝伐单抗相比,单纯化疗在OS和PFS方面无显著差异.化疗联合靶向治疗对这些患者没有带来生存益处。证明了为这一人群开发新的治疗方案的重要性。
方法：按照一线治疗方案（单纯化疗/化疗联合贝伐单抗）对61例患者进行分组。
结果：单纯化疗与化疗联合贝伐单抗治疗患者的OS无显著差异（P=0.93；HR，
结论：对于BRAFV600E突变的晚期CRC患者，
