Mehmet Artaç1, Hasan Şenol Coşkun2, Faysal Dane3, Bülent Karabulut4, Levent Korkmaz5, Mustafa Karaağaç5, Devrim Çabuk6, Senem Karabulut7, Nuri Faruk Aykan7, Hatice Doruk8, Nilüfer Avcı9, Nazım Serdar Turhal10. 1. Department of Medical Oncology, Necmettin Erbakan University, Meram Medical Faculty, 42080, Konya, Turkey. mehmetartac@yahoo.com. 2. Department of Medical Oncology, Akdeniz University Faculty of Medicine, Antalya, Turkey. 3. Department of Medical Oncology, Marmara University Faculty of Medicine, Istanbul, Turkey. 4. Department of Medical Oncology, Ege University Faculty of Medicine, Izmir, Turkey. 5. Department of Medical Oncology, Necmettin Erbakan University, Meram Medical Faculty, 42080, Konya, Turkey. 6. Department of Medical Oncology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey. 7. Department of Medical Oncology, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey. 8. Department of Medical Oncology, Acıbadem Bursa Hospital, Bursa, Turkey. 9. Department of Medical Oncology, Ali Osman Sönmez Oncology Hospital, Bursa, Turkey. 10. Department of Medical Oncology, Anadolu Medical Center, Istanbul, Turkey.
Abstract
BACKGROUND: Several chemotherapy regimens using bevacizumab have been developed. Our goal was to investigate regimens that have demonstrated significant clinical activity in patients with metastatic colorectal cancer (mCRC). MATERIALS AND METHODS: Six hundred and sixty six patients with mCRC who received first-line chemotherapy combination with bevacizumab were studied. Fluoropyrimidine (F) plus irinotecan (I)-based (FI-bev), F plus oxaliplatin (O)-based (FO-bev), and F-based (F-bev) treatment regimens were compared with respect to progression-free survival (PFS) and overall survival (OS). RESULTS: The median PFS of FI-bev (n = 414) was 10.9 months (95 % CI 10-11.8), of FO-bev (n = 211) was 9.4 months (95 % CI 8.3-10.4), and of F-bev (n = 41) was 9.5 months (95 % CI 5.9-13.1) (p = 0.089). The median OS of FI-bev was 26.3 months (95 % CI 21.7-30.9), of FO-bev was 27 months (95 % CI 24.3-29.7), and of F-bev was 23.3 months (95 % CI 12.7-33.9) (p = 0.102). In KRAS wild-type patients, the median PFS of FI-bev group was significantly longer than FO-bev group (10.5 vs. 9.1 months, p = 0.006). The FI-bev group had better OS than FO-bev group with borderline significance (p = 0.058). The FI-bev group had significantly longer OS than F-bev group. Patients who underwent metastasectomy or those with Eastern Cooperative Oncology Group performance status (ECOG-PS) ≤1 had longer PFS and OS independent of the type of chemotherapy regimen. CONCLUSION: FI-bev may be the preferred frontline regimen for patients with KRAS wild-type mCRC. Metastasectomy and performance score were the strongest positive predictors of OS and PFS regardless of backbone chemotherapy regimen.
BACKGROUND: Several chemotherapy regimens using bevacizumab have been developed. Our goal was to investigate regimens that have demonstrated significant clinical activity in patients with metastatic colorectal cancer (mCRC). MATERIALS AND METHODS: Six hundred and sixty six patients with mCRC who received first-line chemotherapy combination with bevacizumab were studied. Fluoropyrimidine (F) plus irinotecan (I)-based (FI-bev), F plus oxaliplatin (O)-based (FO-bev), and F-based (F-bev) treatment regimens were compared with respect to progression-free survival (PFS) and overall survival (OS). RESULTS: The median PFS of FI-bev (n = 414) was 10.9 months (95 % CI 10-11.8), of FO-bev (n = 211) was 9.4 months (95 % CI 8.3-10.4), and of F-bev (n = 41) was 9.5 months (95 % CI 5.9-13.1) (p = 0.089). The median OS of FI-bev was 26.3 months (95 % CI 21.7-30.9), of FO-bev was 27 months (95 % CI 24.3-29.7), and of F-bev was 23.3 months (95 % CI 12.7-33.9) (p = 0.102). In KRAS wild-type patients, the median PFS of FI-bev group was significantly longer than FO-bev group (10.5 vs. 9.1 months, p = 0.006). The FI-bev group had better OS than FO-bev group with borderline significance (p = 0.058). The FI-bev group had significantly longer OS than F-bev group. Patients who underwent metastasectomy or those with Eastern Cooperative Oncology Group performance status (ECOG-PS) ≤1 had longer PFS and OS independent of the type of chemotherapy regimen. CONCLUSION:FI-bev may be the preferred frontline regimen for patients with KRAS wild-type mCRC. Metastasectomy and performance score were the strongest positive predictors of OS and PFS regardless of backbone chemotherapy regimen.
Entities:
Keywords:
Fluoropyrimidine plus bevacizumab; Irinotecan plus bevacizumab; Metastatic colorectal cancer; Oxaliplatin plus bevacizumab
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