Bevacizumab every 4 weeks is as effective as every 2 weeks in combination with biweekly FOLFIRI in metastatic colorectal cancer
Journal of Cancer Research & Clinical Oncology, 07/11/2012
Yildiz R et al. – Bevacizumab 5mg/kg every 2weeks or every 4weeks in combination with biweekly FOLFIRI had similar efficacy and tolerability in metastatic colorectal cancer (mCRC). Because of the retrospective nature of the study, the data should be examined cautiously. However, the study clearly points out the need for determination of optimum biological dosing interval of bevacizumab in well–designed, prospective, randomized trials.Methods
- A total of 332 patients from six centers were evaluated.
- The patients had received biweekly FOLFIRI in combination with bevacizumab 5 mg/kg every 2 weeks or every 4 weeks schedule for various reasons in individual patients.
- Approximately 70 % of all patients had 2–week treatment schedule.
- In the first–line therapy (n = 240), the overall response rate (ORR) was 34.1 % in 2–week and 36.3 % in 4–week groups.
- Median progression–free survival (PFS) was 8 months (95 %CI, 6.8–9.2) and 9 months (95 %CI, 6.6–11.4) (p = 0.074), and median overall survival (OS) was 22 months (95 %CI, 15.8–28.2) and 20 months (95 %CI, 8.1–31.9) (p = 0.612) in 2– and 4–week groups, respectively.
- One–year survival rate was 76.2 % for 2–week group and 73.2 % for 4–week group. In the second–line therapy (n = 92), the ORR was similar between the groups (24.5 vs 25.9 % in 2– and 4–week groups, respectively).
- Median PFS was 6 months (95 %CI, 4.7–7.3) and 11 months (95 %CI, 6.3–15.7) (p = 0.074), and median OS was 15 months (95 %CI, 9.6–20.4) and 17 months (95 %CI, 13.7–20.3) (p = 0.456) for 2–week and for 4–week groups, respectively.
- One–year survival rate was 61.3 % for 2–week and 71.3 % for 4–week groups.
- Toxicity profile was similar in 2– and 4–week groups and included neutropenia, febrile neutropenia, nausea and vomiting, diarrhea, mucositis, bleeding, hypertension, thromboembolism and fistulization.