Issue: Vojnosanit Pregl 2017; Vol. 74 (No. 3)
Efficacy and safety of bevacizumab in combination with irinotecan and capecitabine in first-line treatment of metastatic colorectal cancer
Authors:
Saša Jungić, Biljana Tubić, Radoslav Gajanin, Zdenka Gojković, Ivanka Rakita
Background/Aim. The efficacy and safety of bevacizumab(BEV) in combination with capecitabin and irinotecan in first-line
therapy for patients with metastatic colorectal cancer (mCRC) were
studied. In order to improve safety and efficacy of chemotherapy,
as well as to reduce adverse reactions to a minimum, doses of active
agents applied were changed in relation to previously employed
schedules. Methods. Patients with histologically documented
mCRC with no previously received chemotherapy or with received
adjuvant or neoadjuvant chemotherapy, which ended 6 months before
capecitabin treatment (1000 mg/m2 per os from the 2nd to 8th
day of each cycle), irinotecan (175 mg/m2 iv every 2 weeks), plus
bevacizumab (5 mg/kg iv every 2 weeks) were observed. Results.
This prospective study included 35 patients of both sexes. The
overall response rate (ORR) of 28.6%, partial response (PR) of
28.6%, progressive disease (PD) of 28.6% and stable disease (SD)
of 42.8% were found. The progression-free survival (PFS) of the
analyzed patients was 11.3 (95% CL: 9.1–12.9) months while overall
survival (OS) of the included patients was 25.2 (95% CL: 17.4–
28.4) months and 117 adverse effects were recorded in 24 patients.
Alopecia, nausea and vomiting, hemorrhage, hand-foot syndrome,
diarrhea, abdominal pain, proteinuria, and hypertension (51.4%,
37.1%, 37.1%, 25.7%, 22.8%, 20.0%, 20.0% and 17.1%,
respectively) were most frequently observed adverse effects. Conclusion.
The results of this clinical trial support and recommend
the use of bevacizumab plus capecitabin and irinotecan in the doses
and schedule applied throughout this study as the first-line treatment
of mCRC patients.
