Bevacizumab plus capecitabine as later-line treatment for patients with metastatic colorectal cancer refractory to irinotecan, oxaliplatin, and fluoropyrimidines

Sci Rep. 2021 Mar 29;11(1):7118. doi: 10.1038/s41598-021-86482-x.

Abstract

There is an unmet medical need for later-line treatment options for patients with metastatic colorectal cancer (mCRC). Considering that, beyond progression, co-treatment with bevacizumab and cytotoxic chemotherapy showed less toxicity and a significant disease control rate, we aimed to evaluate the efficacy of capecitabine and bevacizumab. This single-center retrospective study included 157 patients between May 2011 and February 2018, who received bevacizumab plus capecitabine as later-line chemotherapy after progressing with irinotecan, oxaliplatin, and fluoropyrimidines. The study treatment consisted of bevacizumab 7.5 mg/kg on day 1 and capecitabine 1,250 mg/m2 orally (PO) twice daily on day 1 to 14, repeated every 3 weeks. The primary endpoint was progression-free survival (PFS). The median PFS was 4.6 months (95% confidence interval [CI] 3.9-5.3). The median overall survival (OS) was 9.7 months (95% CI 8.3-11.1). The overall response rate was 14% (22/157). Patients who had not received prior targeted agents showed better survival outcomes in the multivariable analysis of OS (hazard ratio [HR] = 0.59, 95% CI 0.43-0.82, P = 0.002) and PFS (HR = 0.61, 95% CI 0.43-0.85, P = 0.004). Bevacizumab plus capecitabine could be a considerably efficacious option for patients with mCRC refractory to prior standard treatments.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Bevacizumab / administration & dosage*
  • Capecitabine / administration & dosage*
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / pathology
  • Drug Resistance, Neoplasm
  • Female
  • Humans
  • Irinotecan / therapeutic use
  • Male
  • Middle Aged
  • Neoplasm Metastasis / drug therapy*
  • Oxaliplatin / therapeutic use
  • Pyrimidines / therapeutic use
  • Survival Analysis

Substances

  • Pyrimidines
  • Oxaliplatin
  • Bevacizumab
  • Capecitabine
  • Irinotecan