文章：

日本转移性结直肠癌患者的治疗序列：一线至五线治疗的真实世界证据

Treatment Sequences in Patients with Metastatic Colorectal Cancer in Japan: Real-World Evidence of First- to Fifth-Line Treatments

原文发布日期：12 December 2025

DOI: 10.3390/cancers17243962

类型: Article

开放获取: 是

英文摘要：

Background:The development of later-line drugs for metastatic colorectal cancer (mCRC) has expanded treatment options. However, real-world evidence of treatment sequences and transition rates from early- to later-line treatments are limited.Patients and methods:This was a retrospective study using hospital administrative data from patients in Japan who underwent colorectal cancer surgery or first-line treatment after January 2017. Transition rates were calculated and treatment sequences were summarized using a Sankey diagram. Logistic regression was performed to identify factors associated with the transition from second- to third-line treatment.Results:In total, 27,100 patients (median age: 69 years) were included in the study population. Transition rates to subsequent treatment lines from first to fifth ranged from 66.6% to 71.3% (first to second: 69.4%; second to third: 71.3%; third to fourth: 71.1%; fourth to fifth: 66.6%). Among 9061 patients who received second-line treatment, 6456 continued to third-line treatment, and 2605 received the best supportive care. Longer first- (≥180 days; OR: 1.24; 95% CI: 1.13–1.37) and second-line (≥120 days; OR: 1.70; 95% CI: 1.55–1.86) treatment durations were significant factors for continuing to third-line treatment. Prior therapy with oxaliplatin and irinotecan plus molecular targeted drugs was also associated with a higher likelihood of proceeding to third-line treatment (OR: 1.41; 95% CI: 1.27–1.56).Conclusions:This study describes the current mCRC treatment landscape in Japan. Considering the findings, appropriate early treatments are critical for transition to later-line treatment. Additionally, many later-line options are necessary to provide treatment continuation opportunities for better outcomes.

摘要翻译： 

背景：转移性结直肠癌（mCRC）后线治疗药物的研发拓展了治疗选择。然而，关于治疗序列及从前线向后线治疗过渡率的真实世界证据仍较为有限。 患者与方法：本研究为回顾性研究，利用日本2017年1月后接受结直肠癌手术或一线治疗患者的医院管理数据。计算治疗过渡率，并通过桑基图总结治疗序列。采用逻辑回归分析确定与从二线过渡至三线治疗相关的因素。 结果：研究共纳入27,100例患者（中位年龄：69岁）。从一线至五线治疗的后续治疗过渡率介于66.6%至71.3%之间（一线至二线：69.4%；二线至三线：71.3%；三线至四线：71.1%；四线至五线：66.6%）。在9,061例接受二线治疗的患者中，6,456例继续接受三线治疗，2,605例接受最佳支持治疗。较长的一线（≥180天；OR：1.24；95% CI：1.13–1.37）和二线（≥120天；OR：1.70；95% CI：1.55–1.86）治疗持续时间是继续接受三线治疗的重要影响因素。既往接受奥沙利铂和伊立替康联合分子靶向药物治疗也与更高的三线治疗可能性相关（OR：1.41；95% CI：1.27–1.56）。 结论：本研究描述了日本当前mCRC的治疗现状。研究结果表明，恰当的前线治疗对于向后线治疗过渡至关重要。此外，需要提供多种后线治疗方案，以确保持续治疗机会，从而改善患者预后。

原文链接：

Treatment Sequences in Patients with Metastatic Colorectal Cancer in Japan: Real-World Evidence of First- to Fifth-Line Treatments