『大腸癌治療ガイドライン医師用 2016年版』

1 - 1 2016 2016 7 1 85 5- FU tegafur tegafur-uracil UFT doxifluridine 5'-DFUR carmofur HCFU tegafur-gimeracil-oteracilpotassium S-1 UFT leucovorin LV capecitabine Cape regorafenib, trifluridine-tipiracilhydrochloride TAS-102 5- FU mitomycinC irinotecan IRI 5- FU l-leucovorin l-LV oxaliplatin OX bevacizumab Bmab ramucirumab Rmab cetuximab Cmab panitumumab Pmab OX IRI Bmab OX IRI Bmab Cmab Pmab RAS KRAS/NRAS 4 1 3 1 1,500/mm3 100.

2 000/mm3 Rmab RAISE * 5- FU l-LV IRI PS 0 PS 1 PS 2 PS 4 III *RAISE OX Bmab FOLFIRI+Rmab FOLFIRI+placebo III TAS-102 J-003 * RECOURSE ** PS 0 PS 1 PS 2 PS 4 III *J-003 OX IRI TAS-102 placebo II **RECOURSE OX IRI Bmab Cmab/Pmab KRAS TAS-102 placebo III RAS KRAS/NRAS 50% Cmab Pmab RAS KRAS/NRAS EGFR Cmab Pmab 2015 4 RAS KRAS/NRAS BRAFV600E 10% TRIBE * BRAFV600E FOLFOXIRI Bmab 2016 2 NCCN BRAFV600E EGFR Cmab Pmab RAS BRAFV600E BRAFV600E TRIBE * FOLFOXIRI+Bmab FOLFIRI+Bmab III MSI-high MMR MLH1 5% MSI-high

3 MSI-high PD-1 2016 2 NCCN , 70 , 70 Stage II 5-FU MMR MSI MSI 2017 1 R0 Stage III 2 1,500/mm3 5 FU+l-LV UFT+LV Cape FOLFOX CapeOX S-1 Stage III S-1 UFT LV RCT ACTS-CC 2 Stage III Rb S Cape RCT JCOG 0910)3 Stage II B/III UFT LV RCT 18 6 JFMC33-0502 4 OX JFMC41-1001-C2.

4 JOIN 5 Stage III P UFT RCT132-134 NSAS-CC Stage II/ III RS P S-1 UFT RCT ACTS-RC 7 FOLFOX/CapeOX/SOX+Bmab*1 FOLFIRI+Bmab*1 FOLFIRI/IRIS/IRI+Bmab*1orFOLFIRI+Rmab*1, *4 FOLFOX/CapeOX/SOX+Bmab*1 IRI*5+Cmab/Pmab*2orCmab/Pmab*2 IRI*5+Cmab/Pmab*2orCmab/Pmab*2 FOLFIRI/IRI+Cmab/Pmab*1, *2 regorafenib*6or *7 FOLFOX+Cmab/Pmab*1, *2TA S-102*8or *7regorafenib*6or *7TA S-102*8or *7regorafenib*6or *7TA S-102*8or *7regorafenib*6or *7TA S-102*8or *7regorafenib*6or *7TA S-102*8or *7regorafenib*6or *7TA S-102*8or *7regorafenib*6or *7TA S-102*8or *7regorafenib*6or *7TA S-102*8or *7 FOLFIRI+Cmab/Pmab*1, *2 FOLFOX/CapeOX/SOX+Bmab*1 FOLFOXIRIorFOLFOXIRI+BmabIRI*5+Cmab/Pmab *2orCmab/Pmab*2 FOLFOX+Cmab/Pmab*1, *2 FOLFIRI/IRIS/IRI+Bmab*1orFOLFIRI+Rmab*1, *4FL*3/Cape/UFT+LV/S-1+Bmab*1 regorafenib*6or *7TA S-102*8or *7regorafenib*6or *7TA S-102*8or *7regorafenib*6or *7TA S-102*8or *7regorafenib*6or *7TA S-102*8or *7regorafenib*6,*9or *7TA S-102*8.

5 *9or *7regorafenib*6or *7TA S-102*8or *7 or FL*3/Cape/UFT+ LV/ S-1+Bmab*1*1 Bmab Rmab Cmab Pmab *2 RAS KRAS/NRAS *3 Infusional5-FU l-LV*4 *5 IRI *6 7 *7 PS2 *8 8 / CQ A Bevacizumab, Cetuximab, Panitumumab (1A ) CQ CQ A Bmab 2B EGFR EGFR 1D 2C CQ Regorafenib TAS-102 A: PS 0- 1A CQ