In a nutshell
This study investigated the best first-line therapy to add to bevacizumab (Avastin) treatment in patients with metastatic (spread to other parts of the body) colorectal cancer (mCRC). Researchers suggested that irinotecan (Camptosar) plus bevacizumab improved the outcomes of these patients.
Some background
Colorectal cancer is one of the most common cancers worldwide. Up to 50% of patients develop a recurrence (when cancer comes back). In advanced cases, the standard treatment might have limited effectiveness. The addition of other agents to the treatment improves benefits and survival outcomes.
Bevacizumab is a type of targeted therapy that stops the growth of tumor blood vessels. Without blood vessels, tumor growth slows down. This treatment alone and in combination with chemotherapy was approved for mCRC. However, the best chemotherapy to add to this treatment is still to be determined.
Methods & findings
This study included information about 151 patients with mCRC. All patients were treated with bevacizumab as first- and second-line treatment. 40 of these patients received double-dose bevacizumab after the first progression. The chemotherapy regimens added to the treatment were FOLFIRI (5-fluorouracil, leucovorin, and irinotecan)/CAPIRI (capecitabine and irinotecan) and FOLFOX4 (5-fluorouracil, leucovorin, and oxaliplatin)/CAPEOX (capecitabine and oxaliplatin).
Irinotecan-based chemotherapy improved survival without cancer worsening and time to treatment failure by 31%. However, there was no significant difference in overall survival between irinotecan– and oxaliplatin-based regimens.
Re-treatment with the same drug used in the initial therapy was the best option to improve overall survival after the first progression. These patients had an overall survival of 46.5 months while patients who switched the treatment drug had an overall survival of 27 months.
The bottom line
This study concluded that first-line mCRC treatment with irinotecan-based chemotherapy plus bevacizumab improved progression outcomes.
The fine print
This study was based on medical records. Some information might have been incomplete. This might affect the results.
Published By :
PLOS ONE
Date :
Apr 29, 2021
