Abstract
Efficacy of chemotherapy plus bevacizumab has been shown in patients with metastatic colorectal cancer (mCRC) compared with chemotherapy alone. The aim of the present study was to evaluate the efficacy and safety of FOLFIRI or XELIRI regimens in combination with bevacizumab for mCRC patients in a first-line setting. A total of 132 patients with previously untreated and histologically confirmed mCRC were included. They were treated with either FOLFIRI-Bevacizumab (Bev) or XELIRI-Bev according to physician preference. The efficacy and safety of the two regimens were compared. Between 2006 and 2010, 68 patients were treated with the XELIRI-Bev regimen, while the remaining 64 patients received the FOLFIRI-Bev regimen. The median age was 58.5 years (53.6 years in the FOLFIRI-Bev and 59.7 years in the XELIRI-Bev arm, p=0.01). Objective response rate was 51.6% for FOLFIRI-Bev versus 41.2% for XELIRI-Bev (p=0.38). At the median follow-up of 24.5 months, the median progression-free survival (PFS) was not different between two groups (14.2 months in FOLFIRI-Bev vs. not reached in the XELIRI-Bev, p=0.30). However, median overall survival time for the FOLFIRI-Bev arm was better than that for patients treated with XELIRI- Bev, but these differences was not statistically significant (37.8 months vs. 28.7 months, respectively, p=0.58). Most commonly reported grade 3-4 toxicities (FOLFIRI-Bev vs XELIRI-Bev) were nausea/vomiting (7.8% vs. 14.7%, p=0.27), diarrhea (10.9% vs 22.1%, p=0.10), hand-foot syndrome (0% vs 8.8%, p=0.02) and neutropenia (18.7% vs 27.9%, p=0.22). Our results showed that FOLFIRI-Bev and XELIRI-Bev regimens were similarly effective treatments in a first-line setting for patients with untreated mCRC, with manageable adverse event profiles.
Highlights
Colorectal cancer (CRC) is the third most commonly diagnosed cancer in males and the second in females
Materials and Methods: A total of 132 patients with previously untreated and histologically confirmed metastatic colorectal cancer (mCRC) were included. They were treated with either FOLFIRI-Bevacizumab (Bev) or XELIRI-Bev according to physician preference
In patients with untreated metastatic CRC, two large randomized trials have shown that the addition of irinotecan to either bolus (IFL) or infusional 5-fluorouracil (5-FU)/leucovorin (LV) (FOLFIRI) significantly imroved response rate, progression-free survival (PFS) and overall survival (OS) compared with 5-FU/LV regimen alone in patients with untreated metastatic CRC (Douillard et al, 2000; Saltz et al, 2000)
Summary
Colorectal cancer (CRC) is the third most commonly diagnosed cancer in males and the second in females. Some randomized phase II an done phase III trials have compared the efficacy and safety of XELIRI and FOLFIRI regimens combined with Bev for patients with metastatic colorectal cancer in the first-line setting (Pectasides et al, 2012; Renouf et al, 2012; Souglakos et al, 2012; Ducreux et al, 2013). These studies demonstrated that XELIRI-Bev and FOLFIRI-Bev are effective treatment modalities with different toxicity profiles. We compared the efficacy and safety of XELIRI-Bev and FOLFIRI-Bev in chemo-naive patients with metastatic CRC
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