Tivozanib is as effective as bevacizumab when combined with mFOLFOX6 in metastatic colorectal cancer

This study compared the effectiveness of the chemotherapy mFOLFOX6 combined with tivozanib (Tivopath) or bevacizumab (Avastin) 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. mFOLFOX chemotherapy combines 5-fluorouracil, leucovorin and oxaliplatin. More recently, the addition of targeted therapies like bevacizumab, that blocks the tumor from growing, has been described to provide an additional benefit. Tivozanib is also a treatment that blocks tumor growth.

It is not clear whether tivozanib combined with mFOLFOX6 is as effective as bevacizumab combined with mFOLFOX6.

This study included 177 metastatic colorectal cancer patients treated with mFOLFOX6 with tivozanib (group 1) and 88 patients treated with mFOLFOX6 and bevacizumab (group 2). Patients received mFOLFOX6 every 2 weeks on day 1 and 15 of each 28-day cycle with either tivozanib or bevacizumab. Patients were checked every 8 weeks (by x-ray or MRI) for tumor progression. Treatment side effects were also reported.

The average progression free survival (time from treatment until disease progression) for group 1 was 9.4 months and 10.7 months for group 2. 45.2% of group 1 and 43.2% of group 2 showed a response to treatment (such as tumor shrinkage). The response lasted for 7.4 months for group 1 and 9.3 months for group 2. 

The most common negative effect was diarrhea (58.2% for group 1 and 57.5% for group 2) and the most common severe effect was low levels of white blood cells (39.5% for group 1 and 24.1% for group 2).

This study concluded that mFOLFOX6 plus tivozanib and mFOLFOX6 plus bevacizumab have comparable effectiveness in patients with metastatic colorectal cancer.