DOI QR코드

DOI QR Code

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

  • Duran, Ayse Ocak (Department of Medical Oncology, Erciyes University) ;
  • Karaca, Halit (Department of Medical Oncology, Erciyes University) ;
  • Besiroglu, Mehmet (Department of Medical Oncology, Marmara University) ;
  • Bayoglu, Ibrahim Vedat (Department of Medical Oncology, Izmir Katip Celebi University, Ataturk Training and Research Hospital) ;
  • Menekse, Serkan (Department of Medical Oncology, Celal Bayar University) ;
  • Yapici, Heves Surmeli (Department of Medical Oncology, Kartal Training and Research Hospital) ;
  • Yazilitas, Dogan (Department of Medical Oncology, Konya Training and Research Hospital) ;
  • Bahceci, Aykut (Department of Medical Oncology, Cumhuriyet University) ;
  • Uysal, Mukremin (Department of Medical Oncology, Afyon Kocatepe University) ;
  • Sevinc, Alper (Department of Medical Oncology, Gaziantep University) ;
  • Hacibekiroglu, Ilhan (Department of Medical Oncology, Trakya University) ;
  • Aksoy, Asude (Department of Medical Oncology, Firat University) ;
  • Tanriverdi, Ozgur (Department of Medical Oncology, Mugla University) ;
  • Arpaci, Erkan (Department of Medical Oncology, Sakarya Training and Research Hospital) ;
  • Inanc, Mevlude (Department of Medical Oncology, Kayseri Education and Research Hospital) ;
  • Dane, Faysal (Department of Medical Oncology, Marmara University) ;
  • Ozkan, Metin (Department of Medical Oncology, Erciyes University)
  • Published : 2015.01.06

Abstract

Background: XELOX plus bevacizumab (XELOX-Bev) and FOLFIRI plus Bevacizumab (FOLFIRI - Bev) treatments are an effective strategies patients with metastatic colorectal cancer (mCRC).The aim of this study was to compare efficacy of first-line XELOX-Bev treatment vs FOLFIRI-Bev treatment for mCRC. Materials and Methods: A total of 409 patients with mCRC who received chemotherapy were included and divided into 2 groups. Group 1 (n=298) received XELOX-Bev and Group 2 (n=111) FOLFIRI-Bev. Comparisons were made in terms of overall (OS) and progression-free (PFS) survival, response rate (RR), and grade 3-4 toxicity. Results: Median follow-up was 11 months in Group 1 and 15 months for Group 2. Complete remission was observed in 29 (9.7%) and 2 (1.8%) patients, partial remission in 139 (46.6%) and 27 (24.5%), stable disease in 88 (29.5%) and 49 (44.1%) and progressive disease in 42 (14.1%) and 33 (30.0%) patients in Group 1 and 2, respectively. Median OS was 25 months (range 2-57 months, 95%CI; 22.2-27.7) for Group 1 and 20 months (range 1-67 months, 95%CI; 16.8-23.1) for Group 2 (p=0.036). Median PFS was 9.6 months (range 2-36 months, 95%CI; 8.8-10.4) for Group 1 and 9 months (range 1-44 months, 95%CI; 7.4-10.5) for Group 2 (p=0.019). Objective RR was 56.4% in Group 1 and 26.1% in Group 2 (p<0.001). Conclusions: First-line XELOX-Bev is more effective with a better response rate, prolongation of median PFS/OS, and a superior safety profile compared with FOLFIRI-Bev.

Keywords

Metastatic colorectal cancer;XELOX plus bevacizumab;FOLFIRI plus bevacizumab;comparison

References

  1. Becouarn Y, Cany L, Pulido M, et al (2014). FOLFIRI$^{(R)}$ and bevacizumab in first-line treatment for colorectal cancer patients: safety, efficacy and genetic polymorphisms. BMC Res Notes, 7, 260. https://doi.org/10.1186/1756-0500-7-260
  2. Buchler T, Pavlik T, Melichar B, et al (2014). Bevacizumab with 5-fluorouracil, leucovorin, and oxaliplatin versus bevacizumab with capecitabine and oxaliplatin for metastatic colorectal carcinoma: results of a large registry-based cohort analysis. BMC Cancer, 14, 323. https://doi.org/10.1186/1471-2407-14-323
  3. Cassidy J, Clarke S, Diaz‑Rubio E, et al (2011). XELOX vs FOLFOX‑4 as first‑line therapy for metastatic colorectal cancer: NO16966 updated results. Br J Cancer, 105, 58‑64. https://doi.org/10.1038/bjc.2011.201
  4. Cetin B, Kaplan MA, Berk V, et al (2012). Prognostic factors for overall survival in patients with metastatic colorectal carcinoma treated with vascular endothelial growth factortargeting agents. Asian Pac J Cancer Prev, 13, 1059-63. https://doi.org/10.7314/APJCP.2012.13.3.1059
  5. Colucci G, Gebbia V, Paoletti G, et al (2005). Phase III randomized trial of FOLFIRI versus FOLFOX4 in the treatment of advanced colorectal cancer: a multicenter study of the Gruppo Oncologico Dell'Italia Meridionale. J Clin Oncol, 23, 4866-75. https://doi.org/10.1200/JCO.2005.07.113
  6. Cunningham D, Lang I, Marcuello E, et al (2013). Bevacizumab plus capecitabine versus capecitabine alone in elderly patients with previously untreated metastatic colorectal cancer (AVEX): an open-label, randomised phase 3 trial. Lancet Oncol, 14, 1077-1085. https://doi.org/10.1016/S1470-2045(13)70154-2
  7. Doi T, Boku N, Kato K, et al (2010). Phase I/II study of capecitabine plus oxaliplatin (XELOX) plus bevacizumab as first‑line therapy in Japanese patients with metastatic colorectal cancer. Jpn J Clin Oncol, 40, 913‑920. https://doi.org/10.1093/jjco/hyq069
  8. 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, 49,1236-45 https://doi.org/10.1016/j.ejca.2012.12.011
  9. Diaz-Rubio E, Gomez-Espana A, Massuti B, et al (2012). Firstline XELOX plus bevacizumab followed by XELOX plus bevacizumab or single-agent bevacizumab as maintenance therapy in patients with metastatic colorectal cancer: the phase III MACRO TTD study. Oncologist, 17, 15-25 https://doi.org/10.1634/theoncologist.2011-0249
  10. Falcone A, Cremolini C, Masi G, et al (2013). FOLFOXIRI/ bevacizumab(bev) versus FOLFIRI/bev as first-line treatment in unresectablemetastatic colorectal cancer (mCRC) patients (pts): results of thephase III TRIBE trial by GONO Group. J Clin Oncol 31(Suppl.)[abstract 3505]
  11. Ferrara N, Gerber HP, LeCouter J (2003). The biology of VEGF and its receptors. Nat Med, 9, 669-76. https://doi.org/10.1038/nm0603-669
  12. Fuchs CS, Marshall J, Mitchell E, et al (2007). Randomized, controlled trial of irinotecan plus infusional, bolus, or oral fluoropyrimidines in firstline 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
  13. Grothey A, Sugrue M, Purdie D, et al (2008). Bevacizumab beyond first progression is associated with prolonged overall survival in metastatic colorectal cancer: results from a large observational cohort study (BRiTE). J Clin Oncol, 26, 5326-34. https://doi.org/10.1200/JCO.2008.16.3212
  14. Hasegawa J, Nishimura J, Mizushima T, et al (2014). Neoadjuvant capecitabine and oxaliplatin (XELOX) combined with bevacizumab for high-risk localized rectal cancer. Cancer Chemother Pharmacol, 73, 1079-87. https://doi.org/10.1007/s00280-014-2417-9
  15. Hecht JR, Mitchell E, Chidiac T, et al (2009). A randomized phase IIIB trial of chemotherapy, bevacizumab, and panitumumab compared with chemotherapy and bevacizumab alone for metastatic colorectal cancer. J Clin Oncol, 27, 672-680. https://doi.org/10.1200/JCO.2008.19.8135
  16. Hochster HS, Hart LL, Ramanathan RK, et al (2008). Safety and efficacy of oxaliplatin and fluoropyrimidine regimens with or without bevacizumab as firstline treatment of metastatic colorectal cancer: results of the TREE Study. J Clin Oncol, 26, 3523-9. https://doi.org/10.1200/JCO.2007.15.4138
  17. Kabbinavar FF, Hambleton J, Mass RD, et al (2005). Combined analysis of efficacy: the addition of bevacizumab to fluorouracil/leucovorin improves survival for patients with metastatic colorectal cancer. J Clin Oncol, 23, 3706-12. https://doi.org/10.1200/JCO.2005.00.232
  18. Lopez R, Salgado M, Reboredo M, et al (2010). A retrospective observational study on the safety and efficacy of first-line treatment with bevacizumab combined with FOLFIRI in metastatic colorectal cancer. Br J Cancer, 103, 1536-41. https://doi.org/10.1038/sj.bjc.6605938
  19. Macedo LT, Lima AB, Sasse AD (2012). Addition of bevacizumab to first-line chemotherapy in advanced colorectal cancer: a systematic review and meta-analysis, with emphasis on chemotherapy subgroups. BMC Cancer, 12, 89. https://doi.org/10.1186/1471-2407-12-89
  20. 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
  21. Rosati G, Avallone A, Aprile G, et al (2013). XELOX and bevacizumab followed by single-agent bevacizumab as maintenance therapy as first-line treatment in elderly patients with advanced colorectal cancer: the boxe study. Cancer Chemother Pharmacol, 71, 257-64. https://doi.org/10.1007/s00280-012-2004-x
  22. Sobrero A, Ackland S, Clarke S, et al (2009). Phase IV study of bevacizumab in combination with infusional fluorouracil, leucovorin and irinotecan (FOLFIRI) in first-line metastatic colorectal cancer. Oncology, 77, 113-9.
  23. Stathopoulos GP, Batziou C, Trafalis D, et al (2010). Treatment of colorectal cancer with and without bevacizumab: a phase III study. Oncology, 78, 376-381. https://doi.org/10.1159/000320520
  24. Saltz LB, Clarke S, Diaz-Rubio E, et al (2008). Bevacizumab in combination with oxaliplatin-based chemotherapy as firstline therapy in metastatic colorectal cancer: a randomized phase III study. J Clin Oncol, 26, 2013-19. https://doi.org/10.1200/JCO.2007.14.9930
  25. Sun J, Hu Y, Wu BS, et al (2014). Bevacizumab concomitant with chemotherapy is effective in treating Chinese patients with advanced non-squamous non-small cell lung cancer. Asian Pac J Cancer Prev, 15, 5945-50. https://doi.org/10.7314/APJCP.2014.15.14.5945
  26. Temraz S, Mukherji D, Shamseddine A (2014). Sequencing of treatment in metastatic colorectal cancer: where to fit the target. World J Gastroenterol, 20, 1993-2004. https://doi.org/10.3748/wjg.v20.i8.1993
  27. Tol J, Koopman M, Cats A, et al 2009. Chemotherapy, bevacizumab, and cetuximab in metastatic colorectal cancer. N Engl J Med, 360, 563-72. https://doi.org/10.1056/NEJMoa0808268
  28. Uchima Y, Nishii T, Iseki Y, et al (2014). Retrospective analysis of capecitabine and oxaliplatin (XELOX) plus bevacizumab as a first-line treatment for Japanese patients with metastatic colorectal cancer. Mol Clin Oncol, 2, 134-8
  29. Uygun K, Bilici A, Kaya S, et al (2013). XELIRI plus bevacizumab compared with FOLFIRI plus bevacizumab as first-line setting in patients with metastatic colorectal cancer: experiences at two-institutions. Asian Pac J Cancer Prev, 14, 2283-8. https://doi.org/10.7314/APJCP.2013.14.4.2283
  30. Van Cutsem E, Rivera F, Berry S, et al (2009). Safety and efficacy of first-line bevacizumab with FOLFOX, XELOX, FOLFIRI and fluoropyrimidines in metastatic colorectal cancer: the BEAT study. Ann Oncol, 20, 1842-7. https://doi.org/10.1093/annonc/mdp233
  31. Welch S, Spithoff K, Rumble RB, Maroun J (2010). Bevacizumab combined with chemotherapy for patients with advanced colorectal cancer: a systematic review. Ann Oncol, 21, 1152-62. https://doi.org/10.1093/annonc/mdp533
  32. Zhang YM, Li YQ, Liu ZH, et al (2014). Clinical efficacy of bevacizumab concomitant with pemetrexed in patients with advanced non-small cell lung cancer. Asian Pac J Cancer Prev, 15, 3447-50. https://doi.org/10.7314/APJCP.2014.15.8.3447
  33. Zhu LM, Zhao YZ, Ju HX, et al (2014). Efficacy and safety of bevacizumab in Chinese patients with metastatic colorectal cancer. Asian Pac J Cancer Prev, 15, 6559-64. https://doi.org/10.7314/APJCP.2014.15.16.6559