Abstract
IntroductionFOLFOXIRI plus bevacizumab has a promising efficacy as first-line systemic chemotherapy for metastatic colorectal cancer (mCRC). This study aimed to evaluate the safety and effectiveness of FOLFOXIRI plus antibodies.ResultsFifty-five patients were enrolled (median age: 60 years, males: 25, females: 30). Twenty-six subjects had RAS mutations and 29 had RAS wild-type. Anti-VEGF and anti-EGFR antibodies were administered to 38 and 17 patients, respectively. The most common severe adverse event was neutropenia (51%). The overall response rate (ORR) was 69% (55% with anti-VEGF antibodies and 100% with anti-EGFR antibodies; P = 0.190), and the disease control rate was 98% (stable disease: 16 patients). With a median follow-up period of 18.4 months, the median progression-free survival (mPFS) was 11.0 months and the median overall survival (mOS) was 41.9 months. The mPFS and mOS did not significantly differ between patients treated with anti-EGFR antibodies and those with anti-VEGF antibodies.MethodsWe retrospectively collected data from mCRC patients treated with FOLFOXIRI plus antibodies between March 2014 and December 2017.ConclusionsFOLFOXIRI plus antibody therapy was effective in patients with mCRC. The response rate was higher in patients treated with anti-EGFR antibodies than in those treated with anti-VEGF antibodies.
Highlights
FOLFOXIRI plus bevacizumab has a promising efficacy as first-line systemic chemotherapy for metastatic colorectal cancer
FOLFOXIRI plus antibody therapy was effective in patients with metastatic colorectal cancer (mCRC)
The response rate was higher in patients treated with anti-epidermal growth factor receptor (EGFR) antibodies than in those treated with anti-vascular endothelial growth factor (VEGF) antibodies
Summary
FOLFOXIRI plus bevacizumab has a promising efficacy as first-line systemic chemotherapy for metastatic colorectal cancer (mCRC). The National Comprehensive Cancer Network guideline for mCRC indicates anti-EGFR antibodies only for leftsided colorectal cancer [6]. These findings were based on the doublet plus antibodies therapy, whereas FOLFOXIRI plus antibodies therapies have not been studied thoroughly. The efficacy of the FOLFOXIRI plus bevacizumab therapy was demonstrated in a phase III study, the TRIBE study [3], the efficacy of the FOLFOXIRI plus anti-EGFR antibody therapy was examined in several phase II studies, the MACBETH study [7], the TRIP study [8], and the VOLFI study [9]. There are only a few studies comparing the efficacy of FOLFOXIRI plus anti-EGFR antibody with FOLFOXIRI plus bevacizumab [10]
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