Bevacizumab plus FOLFIRI or FOLFOX in chemotherapy-refractory patients with metastatic colorectal cancer: a retrospective study

<p>Abstract</p> <p>Background</p> <p>The anti-VEGF antibody bevacizumab associated with an irinotecan or oxaliplatin-based chemotherapy was proved to be superior to the chemotherapy alone in first or second line treatment of metastatic colorectal cancer (mCRC). However,...

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Main Authors: Portales Fabienne, Bachet Jean-Baptiste, Lepère Céline, Boyer-Gestin Christine, Assenat Eric, Mitry Emmanuel, Samalin Emmanuelle, Lièvre Astrid, Vaillant Jean-Nicolas, Ychou Marc, Rougier Philippe
Format: Article
Language:English
Published: BMC 2009-09-01
Series:BMC Cancer
Online Access:http://www.biomedcentral.com/1471-2407/9/347
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author Portales Fabienne
Bachet Jean-Baptiste
Lepère Céline
Boyer-Gestin Christine
Assenat Eric
Mitry Emmanuel
Samalin Emmanuelle
Lièvre Astrid
Vaillant Jean-Nicolas
Ychou Marc
Rougier Philippe
author_facet Portales Fabienne
Bachet Jean-Baptiste
Lepère Céline
Boyer-Gestin Christine
Assenat Eric
Mitry Emmanuel
Samalin Emmanuelle
Lièvre Astrid
Vaillant Jean-Nicolas
Ychou Marc
Rougier Philippe
author_sort Portales Fabienne
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>The anti-VEGF antibody bevacizumab associated with an irinotecan or oxaliplatin-based chemotherapy was proved to be superior to the chemotherapy alone in first or second line treatment of metastatic colorectal cancer (mCRC). However, it was reported to have no efficacy in 3<sup>rd </sup>or later-line, alone or with 5FU. The aim of this study was to evaluate the activity of bevacizumab combined with FOLFIRI or FOLFOX in mCRC who have failed prior chemotherapy with fluoropyrimidine plus irinotecan and/or oxaliplatin.</p> <p>Methods</p> <p>Thirty one consecutive patients treated between May 2005 and October 2006 were included in this retrospective study. All of them have progressed under a chemotherapy with fluoropyrimidine plus irinotecan and/or oxaliplatin and received bevacizumab (5 mg/kg) in combination with FOLFIRI or simplified FOLFOX4 every 14 days.</p> <p>Results</p> <p>Ten patients (32.2%) had an objective response (1 CR, 9 PR) and 12 (38.8%) were stabilized. The response and disease control rates were 45.4% and 100% when bevacizumab was administered in 2<sup>nd </sup>or 3<sup>rd </sup>line and 25% and 55% in 4<sup>th </sup>or later line respectively (p = 0.024 and p = 0.008). Among the patients who had previously received the same chemotherapy than that associated with bevacizumab (n = 28) the overall response rate was 35.7% and 39.3% were stabilized. Median progression free survival (PFS) and overall survival (OS) were of 9.7 and 18.4 months respectively. Except a patient who presented a hypertension associated reversible posterior leukoencephalopathy syndrome, tolerance of bevacizumab was acceptable. A rectal bleeding occurred in one patient, an epistaxis in five. Grade 1/2 hypertension occurred in five patients.</p> <p>Conclusion</p> <p>This study suggests that bevacizumab combined with FOLFOX or FOLFIRI may have the possibility to be active in chemorefractory and selected mCRC patients who did not receive it previously.</p>
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spelling doaj.art-1f6d9f04e92e4bd490cc5ffac1130ca52022-12-22T01:06:06ZengBMCBMC Cancer1471-24072009-09-019134710.1186/1471-2407-9-347Bevacizumab plus FOLFIRI or FOLFOX in chemotherapy-refractory patients with metastatic colorectal cancer: a retrospective studyPortales FabienneBachet Jean-BaptisteLepère CélineBoyer-Gestin ChristineAssenat EricMitry EmmanuelSamalin EmmanuelleLièvre AstridVaillant Jean-NicolasYchou MarcRougier Philippe<p>Abstract</p> <p>Background</p> <p>The anti-VEGF antibody bevacizumab associated with an irinotecan or oxaliplatin-based chemotherapy was proved to be superior to the chemotherapy alone in first or second line treatment of metastatic colorectal cancer (mCRC). However, it was reported to have no efficacy in 3<sup>rd </sup>or later-line, alone or with 5FU. The aim of this study was to evaluate the activity of bevacizumab combined with FOLFIRI or FOLFOX in mCRC who have failed prior chemotherapy with fluoropyrimidine plus irinotecan and/or oxaliplatin.</p> <p>Methods</p> <p>Thirty one consecutive patients treated between May 2005 and October 2006 were included in this retrospective study. All of them have progressed under a chemotherapy with fluoropyrimidine plus irinotecan and/or oxaliplatin and received bevacizumab (5 mg/kg) in combination with FOLFIRI or simplified FOLFOX4 every 14 days.</p> <p>Results</p> <p>Ten patients (32.2%) had an objective response (1 CR, 9 PR) and 12 (38.8%) were stabilized. The response and disease control rates were 45.4% and 100% when bevacizumab was administered in 2<sup>nd </sup>or 3<sup>rd </sup>line and 25% and 55% in 4<sup>th </sup>or later line respectively (p = 0.024 and p = 0.008). Among the patients who had previously received the same chemotherapy than that associated with bevacizumab (n = 28) the overall response rate was 35.7% and 39.3% were stabilized. Median progression free survival (PFS) and overall survival (OS) were of 9.7 and 18.4 months respectively. Except a patient who presented a hypertension associated reversible posterior leukoencephalopathy syndrome, tolerance of bevacizumab was acceptable. A rectal bleeding occurred in one patient, an epistaxis in five. Grade 1/2 hypertension occurred in five patients.</p> <p>Conclusion</p> <p>This study suggests that bevacizumab combined with FOLFOX or FOLFIRI may have the possibility to be active in chemorefractory and selected mCRC patients who did not receive it previously.</p>http://www.biomedcentral.com/1471-2407/9/347
spellingShingle Portales Fabienne
Bachet Jean-Baptiste
Lepère Céline
Boyer-Gestin Christine
Assenat Eric
Mitry Emmanuel
Samalin Emmanuelle
Lièvre Astrid
Vaillant Jean-Nicolas
Ychou Marc
Rougier Philippe
Bevacizumab plus FOLFIRI or FOLFOX in chemotherapy-refractory patients with metastatic colorectal cancer: a retrospective study
BMC Cancer
title Bevacizumab plus FOLFIRI or FOLFOX in chemotherapy-refractory patients with metastatic colorectal cancer: a retrospective study
title_full Bevacizumab plus FOLFIRI or FOLFOX in chemotherapy-refractory patients with metastatic colorectal cancer: a retrospective study
title_fullStr Bevacizumab plus FOLFIRI or FOLFOX in chemotherapy-refractory patients with metastatic colorectal cancer: a retrospective study
title_full_unstemmed Bevacizumab plus FOLFIRI or FOLFOX in chemotherapy-refractory patients with metastatic colorectal cancer: a retrospective study
title_short Bevacizumab plus FOLFIRI or FOLFOX in chemotherapy-refractory patients with metastatic colorectal cancer: a retrospective study
title_sort bevacizumab plus folfiri or folfox in chemotherapy refractory patients with metastatic colorectal cancer a retrospective study
url http://www.biomedcentral.com/1471-2407/9/347
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