FOLFIRI or mFOLFOX6 plus bevacizumab are equally efficient as treatment for metastatic colorectal cancer

This study compared the effectiveness of the chemotherapies FOLFIRI plus bevacizumab (Avastin) and mFOLFOX6 plus bevacizumab in metastatic colorectal cancer. Researchers suggested that these two treatments are equally effective.

Roughly 20% of colorectal cancer patients have metastasis (spread to other parts of the body) at the time of diagnosis. Chemotherapy is used in these patients to reduce symptoms and prolong survival. Chemotherapy drugs attack cancer cells, slowing down cancer progression.

Different chemotherapy drugs can be used and often are combined to increase effectiveness. FOLFIRI chemotherapy combines the agents 5-fluorouracil, leucovorin and irinotecan whereas the mFOLFOX chemotherapy combines 5-fluorouracil, leucovorin and oxaliplatin. More recently, the addition of targeted therapies like bevacizumab (Avastin) that block the tumor from growing has been described to provide an additional benefit.

Prior studies suggested that FOLFIRI and FOLFOX have equal anti-tumor capacities for metastatic colorectal cancer.However a comparison of these two lines of treatment combined with bevacizumab has not been determined so far.

The objective of this study was to compare the efficacy of the combined treatments FOLFIRI plus bevacizumab and FOLFOX plus bevacizumab in metastatic colorectal cancer.

This study included patients treated with FOLFIRI + bevacizumab (197 patients) or treated with FOLFOX + bevacizumab (198 patients) for inoperable metastatic colorectal cancer.On day 1 of each 14-day treatment cycle patients received either combined treatment and were checked every 8 weeks (by x-ray or MRI). Treatment side effects were also reported as well as health-related quality of life. Patients were followed for an average of 51.9 months.

The average time without disease progression was 12.1 months for FOLFIRI and 10.7 months for FOLFOX. The average overall survival (time from treatment until death from any cause) was 31.4 months FOLFIRI  and 30.1 months for FOLFOX. The overall response rate was 64% for FOLFIRI and 62% for FOLFOX.

Patients treated with FOLFIRI were more likely to experience severe negative effects like reduced white blood cells. Severe neuropathy (numbness in your hands and feet) was observed only with FOLFOX. There was one death related to the treatment. No difference was seen in health-related quality of life between the two different treatments.

This study concluded that FOLFIRI plus bevacizumab and FOLFOX plus bevacizumab are equally efficient in the treatment of metastatic colorectal cancer.