Influence of different treatment patterns of molecular targeted agents on survival of patients with metastatic colorectal cancer

LI Shanshan; WANG Yan; GE Feijiao; LIN Li; LIU Jianzhi; XU Jianming

Abstract：Objective To explore the influence of anti-VEGF monoclonal antibody and anti-EGFR monoclonal antibody on survival of patients with metastatic colorectal cancer ( mCRC) under different administration patterns. Methods In a retrospective study, the clinical characteristics, targeted therapy and follow-up data were analyzed among 135 mCRC patients ever treated with mo-lecular targeted therapies. The medium overall survival( OS) was compared among different kinds of targeted drugs and different lines of chemotherapy plus targeted therapy. Results Among mCRC patients, the medium OS for patients receiving anti-EGFR monoclonal an-tibody, bevacizumab or anti-EGFR monoclonal antibody plus bevacizumab were 20?7, 24?4 and 41?6 months, respectively. The medi-um OS was significantly longer in mCRC patients receiving anti-EGFR monoclonal antibody plus bevacizumab than anti-EGFR mono-clonal antibody or bevacizumab alone(P<0?05). The medium OS for patients receiving chemotherapy alone as first-line treatment or first-line chemotherapy plus molecular targeted therapies were 30?8 and 21?5 months, respectively( P>0?05) . The medium OS for pa-tients receiving monoclonal antibody after second-line therapy was 37?0 months, higher than 13?7 months for patients receiving chemo-therapy plus monoclonal antibody therapy for either first-line or second-line option with significant difference( P<0?05) . Among patients ever treated with irinotecan, oxaliplatin, fluorouracil, anti-EGFR monoclonal antibody and bevacizumab, the medium OS for patients receiving chemotherapy plus monoclonal antibody used after third-line therapy was 50?6 months, similar with the 41?6 months for pa-tients receiving chemotherapy plus monoclonal antibody used before third-line therapy( P>0?05) . Conclusion Patients ever receiving both bevacizumab and anti-EGFR monoclonal antibody therapies had better survival than those who received either bevacizumab or anti-EGFR monoclonal antibody therapy. Earlier introduction of monoclonal antibody might not associate with better survival. Patients with good tumor biological behavior might benefit from the treatment pattern of chemotherapy before monoclonal antibody.