Article(id=1291704976959623882, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291704892859638107, articleNumber=null, orderNo=null, doi=10.13699/j.cnki.1001-6821.2025.19.007, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1749398400000, receivedDateStr=2025-06-09, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1785896065224, onlineDateStr=2026-08-05, pubDate=1760630400000, pubDateStr=2025-10-17, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1785896065224, onlineIssueDateStr=2026-08-05, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1785896065224, creator=13701087609, updateTime=1785896065224, updator=13701087609, issue=Issue{id=1291704892859638107, tenantId=1146029695717560320, journalId=1246415772164075586, year='2025', volume='41', issue='19', pageStart='2701', pageEnd='2850', issueExtLink='null', onlineDate='null', pubDate='1760630400000', pubDateStr='2025-10-17', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1785896045171, creator='13701087609', updateTime=1785896787712, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1291708007352656266, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291704892859638107, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1291708007352656267, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291704892859638107, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2735, endPage=2740, ext={EN=ArticleExt(id=1291704977186116299, articleId=1291704976959623882, tenantId=1146029695717560320, journalId=1246415772164075586, language=EN, title=Effect of bevacizumab combined with FOLFIRI chemotherapy on advanced colon cancer and its impact on VEGF/VEGFR2 signaling pathway, columnId=1246531407326105792, journalTitle=Chinese Journal of Clinical Pharmacology, columnName=Clinical and Basic Bridging Research, runingTitle=null, highlight=null, articleAbstract=
Objective To investigate the efficacy of bevacizumab combined with 5- fluorouracil+calcium folinate+irinotecan (FOLFIRI) chemotherapy in the treatment of advanced colon cancer and its impact on the vascular endothelial growth factor (VEGF)/vascular endothelial growth factor receptor 2 (VEGFR2) signaling pathway.
Methods The patients with advanced colon cancer admitted to our hospital were divided into control group and experimental group according to the random number table method. The control group was given FOLFIRI chemotherapy regimen: on the first day, irinotecan injection 180 mg·m-2 + 500 mL normal saline was given by intravenous drip ; calcium folinate 400 mg·m-2 + 250 mL normal saline, intravenous infusion, 2 h infusion completed; fluorouracil injection 400 mg·m-2, intravenous injection ; fluorouracil 2 400 mg·m-2,46 h intravenous pumping. The experimental group was treated with bevacizumab on the basis of the control group: after the completion of chemotherapy, bevacizumab 5 mg·kg-1 + 500 mL normal saline was intravenously administered. Both groups were treated for 2 cycles with 14 days as a cycle. The therapeutic effect, tumor markers [colon cancer specific antigen-2 (CCSA-2 ), carcinoembryonic antigen (CEA), thymidine kinase (TK1), carbohydrate antigen 199 (CA199)], vascular endothelial growth factor (VEGF) / VEGF receptor 2 (VEGFR2) signaling pathway factors, immune function (peripheral blood CD3+, CD4+, CD8+, CD4+/CD8+), quality of life [cancer treatment function assessment-colorectal cancer scale (FACT-C) score] and adverse reactions were compared between the two groups, and followed up for 1 year, the 1-year survival rate was compared between the two groups.
Results In this study, 98 patients were screened, all of whom completed the treatment and were followed up for one year. Two patients in the experimental group were lost to follow-up, and one patient in the control group was lost to follow-up. After 2 cycles of treatment, the disease remission rate and disease control rate of the experimental group (55.10%, 69.39%) were higher than those of the control group (34.69%, 44.90%) (P<0.05). After 2 cycles of treatment, the peripheral blood CD3+ in the experimental group and the control group were (60.75±3.29)% and (58.81±3.10)%; CD4+/CD8+ were (1.76±0.40)%, (1.29±0.38)%; CD4+ were (38.65±3.05)%, and (33.12±2.86)% ; the serum CEA was (18.71±4.10) and (23.69±3.68) ng·mL-1; the serum VEGF levels were (236.28±55.79) and (380.44±81.32) pg·mL-1; the serum CA199 levels were (22.48±4.26) and (37.19±4.55) U·mL-1; serum VEGFR2 were (1 131.16±142.53) and (1 514.79±215.41) pg·mL -1 ; serum TK1 was (1.15±0.23) and (1.92±0.31) pmol·L-1, the serum CCSA-2 levels were (15.13±3.06) and (19.04±3.25) ng·mL-1. Peripheral blood CD8+ were (22.02±2.15)%, (25.68±2.62)% ; the peripheral blood CD3+, CD4+/CD8+ and CD4+ in the experimental group were higher than those in the control group, and the serum CEA, VEGF, CA199, VEGFR2, TK1, CCSA-2 and peripheral blood CD8+ were lower than those in the control group (P<0.05). After 2 cycles of treatment, the physical status scores of FACT-C in the experimental group and the control group were (21.35±2.39) and (18.07±3.16) scores; the scores of social / family status were (24.27±1.31) and (20.94±1.75) scores; the scores of emotional status were (18.56±1.81) and (16.17±2.03) scores; the functional status scores were (22.42±1.64) and (19.78±2.18) scores; the specific module scores of colorectal cancer were (30.52±2.18) and (27.16±2.35) scores; the above indexes in the experimental group were higher than those in the control group (P<0.05). The incidence of leukopenia and gastrointestinal reactions in the experimental group (34.69%, 16.33%) was lower than that in the control group (61.22%, 36.73%) (P<0.05). After 1 year of follow-up, the survival rate of the experimental group (80.85%) was higher than that of the control group (62.50%) (P<0.05).
Conclusion The combination therapy of FOLFIRI chemotherapy and bevacizumab for patients with advanced colon cancer can effectively regulate the VEGF/VEGFR2 signaling pathway, reduce tumor marker levels, improve immune function, decrease the occurrence of adverse reactions, enhance treatment efficacy, improve patients’ quality of life, and increase survival rates.
, authors=Zhen-hua LIANG, Juan QI, Chong LI, authorsList=Zhen-hua LIANG, Juan QI, Chong LI, authorCompany=null, correspAuthors=Zhen-hua LIANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1291704977546826444, articleId=1291704976959623882, tenantId=1146029695717560320, journalId=1246415772164075586, language=CN, title=贝伐珠单抗联合FOLFIRI化疗对晚期结肠癌的效果及VEGF/VEGFR2信号通路的影响, columnId=1246531407485489349, journalTitle=中国临床药理学杂志, columnName=临床与基础桥接研究, runingTitle=null, highlight=null, articleAbstract=
目的 探讨贝伐珠单抗联合5-氟尿嘧啶+亚叶酸钙+伊立替康（FOLFIRI）方案化疗治疗晚期结肠癌的效果及对血管内皮生长因子（VEGF）/血管内皮生长因子受体2（VEGFR2）信号通路的影响。
方法 将本院收治的晚期结肠癌患者按随机数字表法分为对照组和试验组。对照组给予FOLFIRI方案化疗：第1 d伊立替康注射液180 mg·m-2+500 mL生理盐水静脉滴注给药；亚叶酸钙400 mg·m-2+250 mL生理盐水，静脉滴注给药，2 h滴注完毕；氟尿嘧啶注射液400 mg·m-2，静脉推注给药；取氟尿嘧啶2400 mg·m-2，46 h静脉泵入。试验组在对照组基础上给予贝伐珠单抗治疗：于化疗治疗完成后，取贝伐珠单抗5 mg·kg-1+500 mL生理盐水，静脉滴注给药。两组均14 d为1个周期，共治疗2个周期。比较两组治疗效果、肿瘤标志物[结肠癌特异性抗原-2（CCSA-2）、癌胚抗原（CEA）、胸苷激酶（TK1）、糖类抗原199（CA199）]、血管内皮生长因子（VEGF）/VEGF受体2（VEGFR2）信号通路因子、免疫功能（外周血CD3+、CD4+、CD8+、CD4+/CD8+）、生存质量[癌症治疗功能评估-结直肠癌量表（FACT-C）评分]及不良反应，并随访1年，比较两组1年生存率。
结果 共纳入98例患者，其中对照组和试验组各49例。治疗后，试验组疾病缓解率和疾病控制率（55.10%、69.39%）均高于对照组（34.69%、44.90%）（P<0.05）；治疗后，试验组和对照组外周血CD3+分别为（60.75±3.29）%和（58.81±3.10）%；CD4+/CD8分别为（1.76±0.40）%和（1.29±0.38）%；CD4+分别为（38.65±3.05）%和（33.12±2.86）%；血清CEA分别为（18.71±4.10）和（23.69±3.68）ng·mL-1；血清VEGF分别为（236.28±55.79）和（380.44±81.32）pg·mL-1；血清CA199分别为（22.48±4.26）和（37.19±4.55）U·mL-1；血清VEGFR2分别为（1 131.16±142.53）和（1 514.79±215.41）pg·mL-1；血清TK1分别为（1.15±0.23）和（1.92±0.31）pmol·L-1；血清CCSA-2分别为（15.13±3.06）和（19.04±3.25）ng·mL-1；外周血CD8+分别为（22.02±2.15）%和（25.68±2.62）%；试验组外周血CD3+、CD4+/CD8、CD4+均高于对照组，血清CEA、VEGF、CA199、VEGFR2、TK1、CCSA-2及外周血CD8+均低于对照组（P<0.05）。治疗2个周期后试验组与对照组FACT-C中躯体状况评分分别为（21.35±2.39）和（18.07±3.16）分；社会/家庭状况评分分别为（24.27±1.31）和（20.94±1.75）分；情绪状况评分分别为（18.56±1.81）和（16.17±2.03）分；功能状况评分分别为（22.42±1.64）和（19.78±2.18）分；结直肠癌特异模块评分分别为（30.52±2.18）和（27.16±2.35）分；试验组上述指标均高于对照组（P<0.05）。试验组白细胞减少、胃肠道反应发生率（34.69%、16.33%）低于对照组（61.22%、36.73%）（P<0.05）；随访1年，试验组生存率（80.85%）高于对照组（62.50%）（P<0.05）。
结论 FOLFIRI方案化疗与贝伐珠单抗联合治疗晚期结肠癌患者可有效调控VEGF/VEGFR2信号通路，降低肿瘤标志物水平，还能改善机体免疫，减少不良反应的发生，有助于提高治疗效果，改善患者生存质量，并能提升生存率。
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梁振华（1982-），女，主治医师，主要从事肿瘤方面疾病治疗研究/工作
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