DOI QR코드

DOI QR Code

Xeliri Plus Bevacizumab Compared with Folfiri Plus Bevacizumab as First-Line Setting in Patients with Metastatic Colorectal Cancer: Experiences at Two-Institutions

  • Uygun, Kazim (Department of Medical Oncology, Kocaeli University, Medical Faculty) ;
  • Bilici, Ahmet (Department of Medical Oncology, Sisli Etfal Education and Research Hospital) ;
  • Kaya, Serap (Department of Medical Oncology, Kocaeli University, Medical Faculty) ;
  • Ustaalioglu, Bala Basak Oven (Department of Medical Oncology, Dr. Lutfi Kirdar Kartal Education and Research Hospital) ;
  • Yildiz, Ramazan (Department of Medical Oncology, Dr. Lutfi Kirdar Kartal Education and Research Hospital) ;
  • Temiz, Suleyman (Department of Medical Oncology, Kocaeli University, Medical Faculty) ;
  • Seker, Mesut (Department of Medical Oncology, Dr. Lutfi Kirdar Kartal Education and Research Hospital) ;
  • Aksu, Gorkem (Department of Radiation Oncology, Kocaeli University, Medical Faculty) ;
  • Cabuk, Devrim (Department of Medical Oncology, Kocaeli University, Medical Faculty) ;
  • Gumus, Mahmut (Department of Medical Oncology, Dr. Lutfi Kirdar Kartal Education and Research Hospital)
  • 발행 : 2013.04.30

초록

Background: 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. Materials and Methods: 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. Results: 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 XELIRIBev, 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). Conclusion: 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.

참고문헌

  1. Bajetta E, Di Bartolomeo M, Mariani L, et al (2004). Italian Trials in Medical Oncology (I.T.M.O.) Group. Randomized multicenter Phase II trial of two different schedules of irinotecan combined with capecitabine as first-line treatment in metastatic colorectal carcinoma. Cancer, 100, 279-87. https://doi.org/10.1002/cncr.11910
  2. Borner MM, Bernhard J, Dietrich D, et al (2005). Swiss Group for Clinical Cancer Research (SAKK), Berne, Switzerland. A randomized phase II trial of capecitabine and two different schedules of irinotecan in first-line treatment of metastatic colorectal cancer: efficacy, quality-of-life and toxicity. Ann Oncol, 16, 282-8. https://doi.org/10.1093/annonc/mdi047
  3. Cartwright T, Lopez T, Vukelja SJ, et al (2005). Results of a phase II open-label study of capecitabine in combination with irinotecan as first-line treatment for metastatic colorectal cancer. Clin Colorectal Cancer, 5, 50-6. https://doi.org/10.3816/CCC.2005.n.016
  4. de Gramont A, Figer A, Seymour M, Homerin M, Hmissi A, et al (2000). Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol, 18, 2938-47.
  5. Douillard JY, Cunningham D, Roth AD, et al (2000). Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomised trial. Lancet, 355,1041-7. https://doi.org/10.1016/S0140-6736(00)02034-1
  6. Ducreux M, Adenis A, Pignon JP, et al (2013). Efficacy and safety of bevacizumab-based combination regimens in patients with previously untreated metastatic colorectal cancer: Final results from a randomised phase II study of bevacizumab plus 5-fluorouracil, leucovorin plus irinotecan versus bevacizumab plus capecitabine plus irinotecan (FNCLCC ACCORD 13/0503 study). Eur J Cancer, [Epub ahead of print].
  7. Feliu J, Salut A, Safont M, et al, ONCOPAZ group, (2008). First-line treatment with bevacizumab plus capecitabine for elderly patients with metastatic colorectal cancer: BECA trial. J Clin Oncol, 26, 15120.
  8. Fernando N, Yu D, Morse M, et al (2005). A phase II study of oxaliplatin, capecitabine and bevacizumab in the treatment of metastatic colorectal cancer. J Clin Oncol, 23, 3556.
  9. Fuchs CS, Marshall J, Mitchell E, et al (2007). Randomized, controlled trial of irinotecan plus infusional, bolus, or oral fluoropyrimidines in first line treatment of metastatic colorectal cancer: results from the BICC-C Study. J Clin Oncol, 25, 4779-86. https://doi.org/10.1200/JCO.2007.11.3357
  10. Hochster HS, Hart LL, Ramanathan RK, et al (2006). Safety and efficacy of oxaliplatin/fluoropyrimidine regimens with or without bevacizumab as first-line treatment of metastatic colorectal cancer (mCRC): Final analysis of the TREEStudy. J Clin Oncol, 24, 3510. https://doi.org/10.1200/JCO.2006.06.7199
  11. Koopman M, Antonini NF, Douma J, et al (2007). Sequential versus combination chemotherapy with capecitabine, irinotecan, and oxaliplatin in advanced colorectal cancer (CAIRO): a phase III randomised controlled trial. Lancet, 370, 135-42. https://doi.org/10.1016/S0140-6736(07)61086-1
  12. Jemal A, Bray F, Center MM, et al (2011). Global cancer statistics. CA Cancer J Clin, 61, 69-90. https://doi.org/10.3322/caac.20107
  13. Ocvirk J, Rebersek M, Boc M (2011). Bevacizumab in firstline therapy of metastatic colorectal cancer: a retrospective comparison of FOLFIRI and XELIRI. Anticancer Res, 31, 1777-82.
  14. Pectasides D, Papaxoinis G, Kalogeras KT, et al (2012). XELIRIbevacizumab versus FOLFIRI-bevacizumab as first-line treatment in patients with metastatic colorectal cancer: a Hellenic Cooperative Oncology Group phase III trial with collateral biomarker analysis. BMC Cancer,12, 271. https://doi.org/10.1186/1471-2407-12-271
  15. Rea DW, Nortier JW, Ten Bokkel Huinink WW, et al (2005). A phase I/II and pharmacokinetic study of irinotecan in combination with capecitabine as first-line therapy for advanced colorectal cancer. Ann Oncol, 16, 1123-32. https://doi.org/10.1093/annonc/mdi227
  16. Reinacher-Schick AC, Kubicka S, Freier W, et al (2008). Activity of the combination of bevacizumab (Bev) with capecitabine/ irinotecan (CapIri/Bev) or capecitabine/oxaliplatin (CapOx/ Bev) in advanced colorectal cancer (ACRC): A randomized phase II study of the AIO Colorectal Study Group (AIO trial 0604). J Clin Oncol, 26, 4030.
  17. Renouf DJ, Welch S, Moore MJ, et al (2012). A phase II study of capecitabine, irinotecan, and bevacizumab in patients with previously untreated metastatic colorectal cancer. Cancer Chemother Pharmacol, 69, 1339-44. https://doi.org/10.1007/s00280-012-1843-9
  18. Rothenberg ML, Meropol NJ, Poplin EA, Van Cutsem E, Wadler S (2001). Mortality associated with irinotecan plus bolus fluorouracil/leucovorin: summary findings of an independent panel. J Clin Oncol, 19, 3801-7.
  19. Saltz LB, Cox JV, Blanke C, et al (2000). Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. Irinotecan Study Group. N Engl J Med, 343, 905-14. https://doi.org/10.1056/NEJM200009283431302
  20. Sobrero AF, Ackland S, Carrion RP, et al (2006). Efficacy and safety of bevacizumab in combination with irinotecan and infusional 5-FU as first-line treatment for patients with metastatic colorectal cancer. J Clin Oncol, 24, 3544.
  21. Souglakos J, Ziras N, Kakolyris S, et al (2012). Randomised phase-II trial of CAPIRI (capecitabine, irinotecan) plus bevacizumab vs FOLFIRI (folinic acid, 5-fluorouracil, irinotecan) plus bevacizumab as first-line treatment of patients with unresectable/metastatic colorectal cancer (mCRC). Br J Cancer, 106, 453-9. https://doi.org/10.1038/bjc.2011.594
  22. Tebbutt NC, Wilson K, Gebski VJ, Cummins MM, Zannino D, et al (2010). Capecitabine, bevacizumab, and mitomycin in first-line treatment of metastatic colorectal cancer: results of the Australasian Gastrointestinal Trials Group Randomized Phase III MAX Study. J Clin Oncol, 28, 3191-8. https://doi.org/10.1200/JCO.2009.27.7723
  23. Tewes M, Schleucher N, Achterrath W, Wilke HJ, Frings S, Seeber Set al (2003). Capecitabine and irinotecan as first-line chemotherapy in patients with metastatic colorectal cancer: results of an extended phase I study. Ann Oncol, 14, 1442-8. https://doi.org/10.1093/annonc/mdg376

피인용 문헌

  1. Treatment of Metastatic Colorectal Cancer With or Without Bevacizumab: Can the Neutrophil/Lymphocyte Ratio Predict the Efficiency of Bevacizumab? vol.15, pp.12, 2014, https://doi.org/10.7314/APJCP.2014.15.12.4781
  2. Clinical Observations on Associations Between the UGT1A1 Genotype and Severe Toxicity of Irinotecan vol.15, pp.7, 2014, https://doi.org/10.7314/APJCP.2014.15.7.3335
  3. Phase II Study on EANI Combined with Hydrochloride Palonosetron for Prevention of Chemotherapy-induced Nausea and Vomiting Following Highly Emetogenic Chemotherapy vol.15, pp.9, 2014, https://doi.org/10.7314/APJCP.2014.15.9.3951
  4. XELOX Plus Bevacizumab vs. FOLFIRI Plus Bevacizumab Treatment for First-line Chemotherapy in Metastatic Colon Cancer: a Retrospective Study of the Anatolian Society of Medical Oncology vol.15, pp.23, 2015, https://doi.org/10.7314/APJCP.2014.15.23.10375
  5. Meta-analysis comparing the safety and efficacy of metastatic colorectal cancer treatment regimens, capecitabine plus irinotecan (CAPIRI) and 5-fluorouracil/leucovorin plus irinotecan (FOLFIRI) vol.36, pp.5, 2015, https://doi.org/10.1007/s13277-014-2970-1