摘要 : We retrospectively evaluated 3136 individuals who did not respond to treatment with fluoropyrimidine and oxaliplatin plus bevacizumab and were then treated with one of five chemotherapy regimens consisting of fluoropyrimidine, iri... 展开 We retrospectively evaluated 3136 individuals who did not respond to treatment with fluoropyrimidine and oxaliplatin plus bevacizumab and were then treated with one of five chemotherapy regimens consisting of fluoropyrimidine, irinotecan, and an angiogenesis inhibitor for metastatic colorectal cancer. Data were collected from a medical claim database provided by Medical Data Vision Co., Ltd. Two regimens performed better in terms of time to treatment failure. Background: Combination therapy comprised of fluoropyrimidine plus irinotecan with an angiogenesis inhibitor is widely used as a second-line treatment for metastatic colorectal cancer (mCRC). Patients and Methods: This retrospective study evaluated the efficacy and safety of fluorouracil and irinotecan (FOLFIRI) plus ramucirumab (RAM); FOLFIRI plus aflibercept (AFL); irinotecan and S-1 (IRIS) plus bevacizumab (BEV); and capecitabine and irinotecan (CAPIRI) plus BEV, with FOLFIRI plus BEV serving as the control among mCRC patients who failed treatment with fluoropyrimidine and oxaliplatin plus BEV. Data were collected from a medical claim database provided by Medical Data Vision Co., Ltd. (Tokyo, Japan). The primary outcome was time to treatment failure (TTF). Secondary outcomes were time to first subsequent therapy (TFST), overall survival (OS), and safety. Results: Among 3,136 patients assessed, TTF was significantly shorter with FOLFIRI plus RAM (adjusted hazard ratio [HR], 1.40; 95% confidence interval [CI], 1.26-1.56; P <.001) and FOLFIRI plus AFL (HR, 1.34; 95% CI, 1.09-1.66; P =.002), and significantly longer with IRIS plus BEV (HR, 0.80; 95% CI, 0.70-0.92; P =.002). TFST was significantly shorter with FOLFIRI plus RAM (HR, 1.32; 95% CI, 1.17-1.49; P <.001); no significant difference in OS was observed. The incidences of neutropenia requiring granulocyte colony-stimulating factor were significantly lower with IRIS plus BEV and CAPIRI plus BEV. Conclusion: Regarding TTF, BEV seemed to be a favorable option compared with RAM and AFL when combined with FOLFIRI, and IRIS might be preferable compared to FOLFIRI when combined with BEV for patients who failed to respond to fluoropyrimidine, oxaliplatin, and BEV. (c) 2021 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/) 收起