Literature DB >> 20516443

Capecitabine, bevacizumab, and mitomycin in first-line treatment of metastatic colorectal cancer: results of the Australasian Gastrointestinal Trials Group Randomized Phase III MAX Study.

Niall C Tebbutt1, Kate Wilson, Val J Gebski, Michelle M Cummins, Diana Zannino, Guy A van Hazel, Bridget Robinson, Adam Broad, Vinod Ganju, Stephen P Ackland, Garry Forgeson, David Cunningham, Mark P Saunders, Martin R Stockler, Yujo Chua, John R Zalcberg, R John Simes, Timothy J Price.   

Abstract

PURPOSE: To determine whether adding bevacizumab, with or without mitomycin, to capecitabine monotherapy improves progression-free survival (PFS) in patients with metastatic colorectal cancer (mCRC) in an open-label, three-arm randomized trial. PATIENTS AND METHODS: Overall, 471 patients in Australia, New Zealand, and the United Kingdom with previously untreated, unresectable mCRC were randomly assigned to the following: capecitabine; capecitabine plus bevacizumab (CB); or capecitabine, bevacizumab, and mitomycin (CBM). We compared CB with capecitabine and CBM with capecitabine for progression-free survival (PFS). Secondary end points included overall survival (OS), toxicity, response rate (RR), and quality of life (QOL).
RESULTS: Median PFS was 5.7 months for capecitabine, 8.5 months for CB, and 8.4 months for CBM (capecitabine v CB: hazard ratio [HR], 0.63; 95% CI, 0.50 to 0.79; P < .001; C v CBM: HR, 0.59; 95% CI, 0.47 to 0.75; P < .001). After a median follow-up of 31 months, median OS was 18.9 months for capecitabine and was 16.4 months for CBM; these data were not significantly different. Toxicity rates were acceptable, and all treatment regimens well tolerated. Bevacizumab toxicities were similar to those in previous studies. Measures of overall QOL were similar in all groups.
CONCLUSION: Adding bevacizumab to capecitabine, with or without mitomycin, significantly improves PFS without major additional toxicity or impairment of QOL.

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Year:  2010        PMID: 20516443     DOI: 10.1200/JCO.2009.27.7723

Source DB:  PubMed          Journal:  J Clin Oncol        ISSN: 0732-183X            Impact factor:   44.544


  141 in total

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Authors:  Nan Soon Wong; Nishan H Fernando; Andrew B Nixon; Stephanie Cushman; Mebea Aklilu; Johanna C Bendell; Michael A Morse; Gerard C Blobe; Jill Ashton; Herbert Pang; Herbert I Hurwitz
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Review 2.  5-Fluorouracil or capecitabine in the treatment of advanced colorectal cancer: a pooled-analysis of randomized trials.

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Journal:  Med Oncol       Date:  2011-04-24       Impact factor: 3.064

3.  Medical oncology: A novel low-toxicity regimen for advanced colorectal cancer?

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4.  Targeted therapies in colorectal cancer: the dos, don'ts, and future directions.

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5.  Bevacizumab increases the risk of gastrointestinal perforation in cancer patients: a meta-analysis with a focus on different subgroups.

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Review 6.  Value of bevacizumab in treatment of colorectal cancer: A meta-analysis.

Authors:  Chun-Ying Qu; Ying Zheng; Min Zhou; Yi Zhang; Feng Shen; Jia Cao; Lei-Ming Xu
Journal:  World J Gastroenterol       Date:  2015-04-28       Impact factor: 5.742

7.  Monitoring the effects of bevacizumab beyond progression in a murine colorectal cancer model: a functional imaging approach.

Authors:  L Heijmen; C J A Punt; E G W Ter Voert; L F de Geus-Oei; A Heerschap; J Bussink; C G J Sweep; V Zerbi; W J G Oyen; P N Span; O Boerman; H W M van Laarhoven
Journal:  Invest New Drugs       Date:  2013-01-17       Impact factor: 3.850

Review 8.  Strategies of sequential therapies in unresectable metastatic colorectal cancer: a meta-analysis.

Authors:  T Asmis; S Berry; R Cosby; K Chan; N Coburn; M Rother
Journal:  Curr Oncol       Date:  2014-12       Impact factor: 3.677

9.  Bevacizumab use and risk of cardiovascular adverse events among elderly patients with colorectal cancer receiving chemotherapy: a population-based study.

Authors:  H-T Tsai; J L Marshall; S R Weiss; C-Y Huang; J L Warren; A N Freedman; A Z Fu; L B Sansbury; A L Potosky
Journal:  Ann Oncol       Date:  2013-02-20       Impact factor: 32.976

10.  Does the addition of drugs targeting the vascular endothelial growth factor pathway to first-line chemotherapy increase complete response? A meta-analysis of randomized clinical trials.

Authors:  Yan Li; Xin-Yue Liang; Yi-Qi Yue; Lei Sheng; Ji-Kai Liu; Zhan-Yu Wang; Gang Chen
Journal:  Tumour Biol       Date:  2015-11-30
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