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上海复旦大学肿瘤医院，复旦大学上海医学院肿瘤学系化疗科 李 进
【 Abstract 】 Colorectal carcinoma (CRC) is the second common cause of death from cancer in developed country. For a long period, patients with metastatic disease were considered incurable except for a small subgroup with isolated surgically complete removable lesions in the lungs and the liver. Remarkable changes in chemotherapy for advanced CRC have occurred since the 1990s. 5-FU/LV has become the standard treatment for mCRC instead of levamisole hydrochloride. In the last 10 years, many in-depth studies have been conducted to optimise the dose and delivery method of 5-FU and LV. These have led to the wide clinical use of the Mayo Clinic, Roswell Park , AIO and de Gramont regimens. The average response rate to 5-FU/LV in treatment of advanced CRC is about 20% and median survival is about 12-15 months. With the advent of capecitabine , oxaliplatin and irinotecan in the late 1990s, the response rate was increased to 50% and median survival to about 20 months by the addition of these drugs. The EGF receptor antibody cetuximab shows activity as single agent and in combination with irinotecan. Combination of cetuximab with oxaliplatin/5-FU showed remarkable results in 2006 ASCO meeting. The VEGF antibody bevacizumab improved efficacy in combination with all chemotherapies. From the updated data, the combination of monoclonal antibodies with chemotherapy will lead to a longer survival for mCRC patients.
【 Abstract 】 Colorectal carcinoma (CRC) is the second common cause of death from cancer in developed country. For a long period, patients with metastatic disease were considered incurable except for a small subgroup with isolated surgically complete removable lesions in the lungs and the liver. Remarkable changes in chemotherapy for advanced CRC have occurred since the 1990s. 5-FU/LV has become the standard treatment for mCRC instead of levamisole hydrochloride. In the last 10 years, many in-depth studies have been conducted to optimise the dose and delivery method of 5-FU and LV. These have led to the wide clinical use of the Mayo Clinic, Roswell Park , AIO and de Gramont regimens. The average response rate to 5-FU/LV in treatment of advanced CRC is about 20% and median survival is about 12-15 months. With the advent of capecitabine , oxaliplatin and irinotecan in the late 1990s, the response rate was increased to 50% and median survival to about 20 months by the addition of these drugs. The EGF receptor antibody cetuximab shows activity as single agent and in combination with irinotecan. Combination of cetuximab with oxaliplatin/5-FU showed remarkable results in 2006 ASCO meeting. The VEGF antibody bevacizumab improved efficacy in combination with all chemotherapies. From the updated data, the combination of monoclonal antibodies with chemotherapy will lead to a longer survival for mCRC patients.