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Predictors of the efficacy of FOLFIRI plus bevacizumab as second-line treatment in metastatic colorectal cancer patients

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Abstract

Purpose

Fluoropyrimidine-based chemotherapy plus bevacizumab (BV) is the standard treatment for metastatic colorectal cancer (mCRC). The aim of this study was to investigate the efficacy of BV plus FOLFIRI (5-fluorouracil, leucovorin, irinotecan) as second-line treatment in mCRC patients refractory to first-line oxaliplatin-based chemotherapy, and determine potential predictive factors affecting survival.

Methods

Thirty-four consecutive patients were included in this retrospective study. All patients received FOLFIRI plus 5 mg/kg BV until progression or unmanageable toxicity occurred. Clinical factors and KRAS status were evaluated as potential biomarkers of efficacy.

Results

The overall response was 23.5%. The median progression-free survival (PFS) and time-to-treatment failure (TTF) were 248 and 221 days, respectively. The median overall survival (OS) was 651 days. A univariate analysis revealed that normal thrombin antithrombin complex, alkaline phosphatase, lactate dehydrogenase, and carbohydrate antigen 125 (CA125) levels at baseline were associated with better PFS, TTF, and OS. A multivariate analysis showed that only the CA125 level at baseline was an independent negative predictor of both PFS and OS. KRAS status was not identified as a predictor.

Conclusions

The results of this study suggest that FOLFIRI plus BV is a viable option in second-line treatment for mCRC refractory to first-line FOLFOX (5-fluorouracil, leucovorin, oxaliplatin) alone, and indicate that CA125 might be a predictive biomarker for the outcome.

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Authors and Affiliations

  1. Department of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Mitsukuni Suenaga, Satoshi Matsusaka, Eiji Shinozaki, Nobuyuki Mizunuma & Kiyohiko Hatake

  2. Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Masashi Ueno & Toshiharu Yamaguchi

  3. Department of Pathology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Noriko Yamamoto

Authors
  1. Mitsukuni Suenaga
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  2. Satoshi Matsusaka
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  3. Masashi Ueno
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  4. Noriko Yamamoto
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  5. Eiji Shinozaki
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  6. Nobuyuki Mizunuma
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  7. Toshiharu Yamaguchi
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  8. Kiyohiko Hatake
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Suenaga, M., Matsusaka, S., Ueno, M. et al. Predictors of the efficacy of FOLFIRI plus bevacizumab as second-line treatment in metastatic colorectal cancer patients. Surg Today 41, 1067–1074 (2011). https://doi.org/10.1007/s00595-010-4432-8

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  • DOI: https://doi.org/10.1007/s00595-010-4432-8

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