Combination of capecitabine and bevacizumab

This study evaluated the use of capecitabine in combination with bevacizumab (Avastin) in the treatment of unresectable metastatic colorectal cancer.

Current treatment of unresectable metastatic colorectal cancer (wide spread cancer that cannot be removed by surgery do to size or location) includes chemotherapy, such as capecitabine, with or without the addition of bevacizumab. Bevacizumab is a commonly used biological treatment which inhibits the growth of new blood vessels necessary for cancer growth and spread. Previous trials have suggested that the combination of chemotherapy and bevacizumab leads to better response rates and prolonged survival compared to chemotherapy alone. However, conclusive high grade evidence regarding the use of capecitabine in combination with bevacizumab is scarce.

40 male and 42 female patients with unresectable colorectal cancer took part in this study. All patients received a combination of capecitabine and bevacizumab in three-week cycles. Computed tomography (CT) scans were performed every nine weeks to assess disease status. 

7% of patients showed complete response to therapy, while 31% of patients showed a partial response. At 9 months after treatment initiation, 35% of patients showed no disease progression. The one-year overall survival rate was 67%. The treatment combination was generally well tolerated with mild to moderate adverse effects. 56% of patients experienced skin reactions and 37% of patients experienced infection. Diarrhea and nausea were the most common adverse effect.

While the combination of capecitabine with bevacizumab improved both progression rate and survival, this trial showed reduced improvements compared to previous trials of a similar nature employing different chemotherapy drugs. Analysis of the data from this study compared to previous studies suggests that bevacizumab with capecitabine is most useful in elderly patients with a relatively symptom-free disease.

This study concluded that the combination of capecitabine and bevacizumab shows good response to treatment and no increased risk of sever adverse effects. However, careful patient selection is essential for treatment success.