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FIRE-3试验旨在比较一线使用FOLFIRI方案联合西妥昔单抗或贝伐单抗治疗592 KRAS基因外显子2野生型转移性结直肠癌患者的疗效。我们在RAS野生型人群（n = 342）中分析性别和原发肿瘤的位置与疗效的关系。

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.