The inhibition of the antiangiogenic pathway in association with chemotherapy significantly improved disease control and overall survival both in the upfront and in second line treatment of metastatic colorectal cancer patients. The VELOUR study had showed a significant improvement in overall survival with the addition of aflibercept, an antiangiogenic chimeric protein, to FOLFIRI (5-flourouracil, leucovorin, irinotecan) in patients who progressed after an oxaliplatin based chemotherapy (with or without bevacizumab) in first line treatment or within 6 months from the completion of adjuvant chemotherapy. Subgroup analyses from VELOUR trial show that the benefit of aflibercept is independent from previous exposure to bevacizumab in first line. We reported the case of a patient affected by metastatic colorectal adenocarcinoma RAS/ BRAF wild-type, with an initial liver-limited presentation. In this case we used a second line treatment with FOLFIRI aflibercept after a first-line oxaliplatin-based chemotherapy plus an anti-EGFR antibody.
L’inibizione del pathway angiogenico in associazione alla chemioterapia standard nel tumore del colon metastatico ha mostrato di migliorare il controllo di malattia sia in prima sia in seconda linea di trattamento. I risultati dello studio di fase III VELOUR hanno portato all’approvazione della proteina di fusione aflibercept in associazione a FOLFIRI nei pazienti sottoposti a chemioterapia a base di oxaliplatino in associazione o meno a bevacizumab in prima linea o in progressione entro 6 mesi dal termine del trattamento adiuvante. Le analisi di sottogruppo evidenziano che il beneficio dall’aggiunta di aflibercept a FOLFIRI è indipendente dalla pregressa esposizione all’antiangiogenico bevacizumab. Riportiamo il caso di una paziente affetta da adenocarcinoma del sigma metastatico RAS e BRAF wild-type, con malattia inizialmente liverlimited e sottoposta a trattamento di seconda linea con chemioterapia e antiangiogenico in seguito all’evidenza di progressione strumentale al trattamento con anti-EGFR e doppietta a base di oxaliplatino.
Adenocarcinoma del colon metastatico. L’inibizione del pathway angiogenico come opzione di trattamento in seconda linea
Masi, Gianluca;
2018-01-01
Abstract
The inhibition of the antiangiogenic pathway in association with chemotherapy significantly improved disease control and overall survival both in the upfront and in second line treatment of metastatic colorectal cancer patients. The VELOUR study had showed a significant improvement in overall survival with the addition of aflibercept, an antiangiogenic chimeric protein, to FOLFIRI (5-flourouracil, leucovorin, irinotecan) in patients who progressed after an oxaliplatin based chemotherapy (with or without bevacizumab) in first line treatment or within 6 months from the completion of adjuvant chemotherapy. Subgroup analyses from VELOUR trial show that the benefit of aflibercept is independent from previous exposure to bevacizumab in first line. We reported the case of a patient affected by metastatic colorectal adenocarcinoma RAS/ BRAF wild-type, with an initial liver-limited presentation. In this case we used a second line treatment with FOLFIRI aflibercept after a first-line oxaliplatin-based chemotherapy plus an anti-EGFR antibody.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
