Sobrevida del cáncer colorrectal metastásico kras no mutado en relación uso becacizumab o cetuximab
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2018
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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INTRODUCCIÓN: La sobrevida del Cáncer Colorrectal Metastásico ha mejorado significativamente en la última década con la adición de terapia dirigida en base estado de mutación de los oncogenes Ras. OBJETIVO: Comparar la sobrevida al cáncer colorrectal metastásico de pacientes con tumores gen KRAS no mutado que recibieron quimioterapia asociada a Bevacizumab o Cetuximab. METODOLOGÍA: Estudio no experimental, analítico y de nivel predictivo para evaluar la sobrevida de pacientes con Cáncer Colorrectal Metastásico gen KRAS no mutado, que recibieron Bevacizumab o Cetuximab dentro de su protocolo de primera línea de tratamiento en el hospital ‘‘Teodoro Maldonado Carbo’’ en el periodo enero 2012-diciembre 2015. La sobrevida global fue estimada mediante curva de Kaplan-Meier (prueba de Mantel-Cox). RESULTADOS: Se obtuvo un total de 43 pacientes. La edad promedio fue 59 años. 27 casos fueron género femenino. El porcentaje de sobrevida a 3 años fue del 30 %. No hubo diferencia estadísticamente significativa en la sobrevida global asociada a Bevacizumab o Cetuximab con un HR = 1.156 (0.581 – 2.299; 0.680) respecto al riesgo asociado al deceso. CONCLUSION: La sobrevida global fueron desenlaces independientes al agente biológico ofertado (Bevacizumab o Cetuximab) se recomienda iniciar con Bevacizumab o un anticuerpo contra el factor de crecimiento epidérmico (Cetuximab ó Panitumumab) de acuerdo a la disponibilidad del stock farmacéutico institucional y dejar uno de los dos agentes para la progresión, a fin de no retrasar el tratamiento.
Survival of Metastatic Colorectal Cancer has significantly improved over the last decade with the addition of targeted therapy based on mutation status of the Ras oncogenes. OBJECTIVE: To compare survival to metastatic colorectal cancer in patients with non-mutated KRAS gene tumors who received chemotherapy associated with Bevacizumab or Cetuximab. METHODOLOGY: Non-experimental, analytical and predictive level study to evaluate the survival of patients with non-mutated KRAS metastatic colorectal cancer, who received Bevacizumab or Cetuximab within their first-line treatment protocol at the hospital '' Teodoro Maldonado Carbo '' in the period January 2012-December 2015. The global survival was estimated using the Kaplan-Meier curve (Mantel-Cox test). RESULTS: A total of 43 patients were obtained. The average age was 59 years. 27 cases were female. The percentage of 3-year survival was 30%. There was no statistically significant difference in the overall survival associated with Bevacizumab or Cetuximab with HR = 1,156 (0.581 - 2.299, 0.680) regarding the risk associated with death. CONCLUSION: The global survival were independent outcomes to the biological agent offered (Bevacizumab or Cetuximab) it is recommended to start with Bevacizumab or an antibody against the epidermal growth factor (Cetuximab or Panitumumab) according to the availability of the institutional pharmaceutical stock and leave one of the two agents for progression, so as not to delay the treatment.
Survival of Metastatic Colorectal Cancer has significantly improved over the last decade with the addition of targeted therapy based on mutation status of the Ras oncogenes. OBJECTIVE: To compare survival to metastatic colorectal cancer in patients with non-mutated KRAS gene tumors who received chemotherapy associated with Bevacizumab or Cetuximab. METHODOLOGY: Non-experimental, analytical and predictive level study to evaluate the survival of patients with non-mutated KRAS metastatic colorectal cancer, who received Bevacizumab or Cetuximab within their first-line treatment protocol at the hospital '' Teodoro Maldonado Carbo '' in the period January 2012-December 2015. The global survival was estimated using the Kaplan-Meier curve (Mantel-Cox test). RESULTS: A total of 43 patients were obtained. The average age was 59 years. 27 cases were female. The percentage of 3-year survival was 30%. There was no statistically significant difference in the overall survival associated with Bevacizumab or Cetuximab with HR = 1,156 (0.581 - 2.299, 0.680) regarding the risk associated with death. CONCLUSION: The global survival were independent outcomes to the biological agent offered (Bevacizumab or Cetuximab) it is recommended to start with Bevacizumab or an antibody against the epidermal growth factor (Cetuximab or Panitumumab) according to the availability of the institutional pharmaceutical stock and leave one of the two agents for progression, so as not to delay the treatment.
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NEOPLASIAS COLORRECTALES, METASTASIS DE LA NEOPLASIA, SOBREVIDA, BEVACIZUMAB, CETUXIMAB, HOSPITAL DE ESPECIALIDADES DR. TEODORO MALDONADO CARBO, CANTON GUAYAQUIL, ECUADOR