Phase II clinical trial of second-line FOLFIRI plus bevacizumab for patients with metastatic colorectal cancer: AVASIRI trial
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FOLFIRI is a standard chemotherapy regimen for the treatment of metastatic colorectal cancer. Although some studies have shown its efficacy in combination with bevacizumab as first-line chemotherapy, there are no data to support FOLFIRI plus bevacizumab as second-line chemotherapy in patients with this form of cancer. The aim of this study was to evaluate the efficacy and safety of FOLFIRI and bevacizumab as second-line chemotherapy in patients with metastatic colorectal cancer.
Eligible patients were ≥20 years old, previously treated (except with irinotecan [CPT-11] and bevacizumab), with an Eastern Cooperative Oncology Group performance status of 0, 1, or 2, and adequate organ function. Twenty-five eligible patients received FOLFIRI with bevacizumab at a dose of 10 mg/kg given intravenously on day 1. All therapy was administered every 2 weeks until disease progression. The primary endpoint was the response rate.
Twenty-five patients were enrolled between February 2008 and March 2009. The median age was 62 (range 38–73) years, the male/female distribution was 20/5, 16 patients had performance status 0 and 9 had performance status 1, and the proportion of patients who were oxaliplatin pretreated/untreated was 16/9. The overall response rate was 32% (90% confidence interval [CI]: 17.0–50.4%), with 8 patients showing partial responses, 15 with stable disease, and 2 with disease progression. Median progression-free survival was 11.6 months (95% CI: 6.9–16.4). Median overall survival was 21.4 months (95% CI: 12.0–30.8). The grade 3/4 adverse events with treatment were neutropenia (64%), leukopenia (16%), diarrhea (8%), anorexia (8%), and febrile neutropenia (8%). The bevacizumab-related grade 3/4 adverse event was hypertension, which was observed in 12% of patients.
The FOLFIRI plus bevacizumab regimen is an active, well-tolerated second-line chemotherapy treatment for patients with metastatic colorectal cancer.
KeywordsFOLFIRI Bevacizumab Second-line Colorectal cancer
We would like to thank Ms. Hideko Morita and Ms. Makiko Shinogi for their help in collecting and organizing the clinical samples, and Ms. Michiyo Tada and Mr Hiroshi Nagai for their help in data management for this study.
Conflict of interest
No author has any conflict of interest.
- 3.Cancer Statistics in Japan Editorial Board. Cancer Statistics in Japan 2008. Foundation for Promotion of Cancer Research 2008 (in Japanese)Google Scholar
- 9.NCCN Clinical Practice Guidelines. http://www.nccn.org/index.asp
- 11.National Cancer Institute—Common Toxicity Criteria (NCI-CTC Version 3.0, March 31, 2003). http://www.jcog.jp
- 12.Giantonio BJ, Catalano PJ, Meropol NJ et al (2007) Bevacizumab in combination with oxaliplatin, fluorouracil, and leucovorin (FOLFOX4) for previously treated metastatic colorectal cancer: results from the Eastern Cooperative Oncology Group Study E3200. J Clin Oncol 25:1539–1544PubMedCrossRefGoogle Scholar
- 14.Muro K, Boku N, Shimada Y et al (2010) Irinotecan plus S-1 (IRIS) versus fluorouracil and folinic acid plus irinotecan (FOLFIRI) as second-line chemotherapy for metastatic colorectal cancer: a randomized phase 2/3 non-inferiority study (FIRIS study). Lancet Oncol 11:853–860PubMedCrossRefGoogle Scholar