FIRE-3试验旨在比较一线使用FOLFIRI方案联合
研究方法
原发肿瘤的位置被定义如下：右侧CRC（RCRC）：盲囊至结肠右曲；左侧CRC（LCRC）：脾曲到直肠。横结肠肿瘤（9例）被排除在外。应用两侧的Fisher检验和对数秩检验分别计算两个治疗组中治疗反应（ORR）和生存期（PFS / OS）的差异。
研究结果
与RCRC相比，LCRC表现出更好的疗效（ORR，PFS和OS），特别是在西妥昔单抗治疗组（表）。与男性患者相比，女性患者有更低的肿瘤反应率，较短的PFS和OS的趋势。
结论
mCRC是一种异质性疾病。治疗的效果取决于原发肿瘤的位置和患者的性别。接受FOLFIRI+西妥昔单抗治疗的男性、左侧CRC患者，疗效更突出。
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会议专题》》》2014年ASCO年会专题报道
阅读原文摘要
Gender and tumor location as predictors for efficacy: Influence on endpoints in first-line treatment with FOLFIRI in combination with cetuximab or bevacizumab in the AIO KRK 0306 (FIRE3) trial.（Abstract Number:3600）
Authors: Volker Heinemann, Dominik Paul Modest, Ludwig Fischer von Weikersthal,et al.
Session Type: General Poster Session
Background: FIRE-3 compared first-line therapy with FOLFIRI plus either cetuximab or bevacizumab in 592 KRAS exon 2 wild-type mCRC patients. We analyzed the efficacy dependent on gender and primary tumor location within the RAS wild-type population (n=342).
Methods: Primary tumor location was defined as follows: right sided CRC (RCRC): coecum to hepatic flexure; left sided CRC (LCRC): splenic flexure to rectum. Colon transversum tumors (n=9) were excluded. Differences in response (ORR) and survival (PFS/OS) within both treatment arms were calculated using two-sided Fisher´s exact and logrank test, respectively.
Results: In location wise comparison LCRC shows better efficacy results (ORR, PFS and OS) when compared with RCRC especially in the cetuximab arm (Table). Female gender has a trend towards lower tumor response rates, shorter PFS and OS when compared to male patients.
Conclusions: MCRC is a heterogeneous disease. Treatment efficacy depends on primary tumor location and patients’ gender. Effects were more prominent in patients receiving FOLFIRI plus cetuximab where male patients with LCRC tumors are favored.
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