Is a combination of capecitabine and irinotecan with bevacizumab effective?

This paper studied the effectiveness and safety of a capecitabine (Xeloda) plus irinotecan (Campto) chemotherapy regimen (XELIRI) with bevacizumab (Avastin) in previously untreated patients with metastatic colorectal cancer (cancer that has spread to other parts of the body). 

Standard treatment for patients with metastatic colorectal cancer usually involves a combination of drugs. Capecitabine plus irinotecan is one such combination. Both treatments block tumor growth. Previous studies have shown that an irinotecan plus capecitabine regimen every 2 weeks was effective and well tolerated. Bevacizumab works by slowing the growth of new blood vessels necessary for tumor growth.  It is not known whether combining bevacizumab with irinotecan and capecitabine is safe and effective.

This study examined 77 patients who received irinotecan and capecitabine followed by bevacizumab for an average of 6.2 months. Patients were followed for an average of 23.3 months.

At 9 months, 61% of patients had survived without disease worsening. Overall, patients survived without disease worsening for an average of 11.9 months. The average overall survival (time from treatment to death from any cause) was 24.8 months. 51% of patients responded to treatment with a decrease in tumor size.

42% of patients were still alive at the end of follow-up. 35 patients died due to disease worsening. 7 patients died due to adverse events (undesired effect of treatment). These events included organ failure, a hole developing through the intestinal wall, breathing difficulties and heart attack.  99% of patients had at least one adverse event related to treatment. 62% of patients had severe or life-threatening adverse events. These events included weakness, diarrhea and low white blood cell levels.

The quality of life of patients did not significantly change during the study period.

The authors concluded that capecitabine and irinotecan plus bevacizumab every 2 weeks was effective and tolerable for patients with metastatic colorectal cancer. 

Talk to your doctor about receiving a combination of capecitabine and irinotecan followed by bevacizumab.