Transcription of KRAS 野生型切除可能大腸癌肝 ... - surgery-smc.jp
1 1 kras mFOLFOX6 mFOLFOX6 III EXPERT 2 2 2003 99,770 / 10 2007 42,172 90% 2 Stage 0-IV Stage 0 III Stage IV Stage 5 Stage 0 StageI StageII Stage IIIa/b StageIV 50-75% 3 5 median survival time MST 8 5 MST 2 1 EORTC40983
2 1 5 68% 5 DFS48% 4 7 5 DFS12% 8 5 9 FOLFOX 5-FU CapeOX FOLFIRI 5-FU VEGF Vascular Endothelial Growth Factor EGFR Epidermal Growth Factor Receptor EGFR 3 EGFR EGFR kras kras 2010 4 EGFR kras kras 87% 40% 80% 111/138 29% 9% 43% Stage II/III FOLFOX 5-FU FOLFOX FOLFOX FOLFOX 12 mFOLFOX6 12 FOLFOX4 6 EORTC40983 3 HR= p= 18% 35% 2% 10% dose intensity 6 EORTC40983 FOLFOX New EPOC
3 EORTC40091 NCCN 2012 1 1 2 2-3 3 2-3 1 2-3 2 2-3 FOLFOX FOLFOX NORDIC VII FLOX COIN 5-FU 4 NCCN 20 25% 40 50% FOLFOX FOLFIRI FOLFIRI 1 FOLFOX6 2 FOLFOX6 FOLFIRI V308 FOLFOX FOLFIRI R0 FOLFOX 13% FOLFIRI 7% FOLFOX 3 EGFR IgG1 - EGFR kras FOLFOX FOLFIRI PFS OS 2 conversion therapy 1), 3) 1),2)
4 kras 5 3 1,000 2 mFOLFOX6 vs mFOLFOX6+ mFOLFOX6 mFOLFOX6 12 mFOLFOX6 6 mFOLFOX6 mFOLFOX6 III 1 EGFR kras 20 ECOG Performance Status PS 0 1 1
5 RFA RECIST 6 6 EGFR 1,500/mm3 100,000/mm3 AST 100IU/L ALT 100IU/L 3 (2) 1 2 URL WEB 3 WEB 4 Appendix 4 ( ) FAX (3) A B 1 4 5 8 7 A mFOLFOX6 12 B mFOLFOX6 6 mFOLFOX6 6 A B A 4 B 2 A mFOLFOX6 B mFOLFOX6 A B 30 (4) 500 250 250 2 2014 5 6 3 10 (5)
6 R0 B 30 8 (6) (7) (8) 9 (9) 049-228-3618 (10) ( ) (11) ( ) 1.
7 Van Cutsem E. et al. Cetuximab Plus Irinotecan, Fluorouracil, and Leucovorin As First-Line Treatment for Metastatic Colorectal Cancer: Updated Analysis of Overall Survival According to Tumor kras and BRAF Mutation Status. J Clin Oncol 2011; 29: 2011-19. 2. Bokemeyer C. et al. Efficacy according to biomarker status of cetuximab plus FOLFOX-4 as first-line treatment for metastatic colorectal cancer: the OPUS study. Ann Oncol. 2011; 22: 1535-46. 3. Folprecht G, et al. Tumour response and secondary resectability of colorectal liver metastases following neoadjuvant chemotherapy with cetuximab: the CELIM randomised phase 2 trial. Lancet Oncol 2010; 11: 38-47.
