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Eur J Endocrinol. 2010 Feb;162(2):349-56. doi: 10.1530/EJE-09-0804. Epub 2009 Nov 10.

Bevacizumab plus capecitabine as a salvage therapy in advanced adrenocortical carcinoma.

Author information

1
Endocrine and Diabetes Unit, Department of Internal Medicine I, University Hospital of Würzburg, University of Würzburg, Oberdürrbacher Strasse 6, 97080 Würzburg, Germany.

Abstract

OBJECTIVE:

No standard therapy for advanced adrenocortical carcinoma (ACC) is established by any randomized trial but a consensus conference 2003 recommended mitotane as monotherapy or combined with etoposide, doxorubicin and cisplatin or with streptozotocin as first-line systemic therapy. However, there is no evidence for any therapy beneficial in patients failing these therapies. Therefore, we evaluated the effects of the anti-VEGF antibody bevacizumab plus capecitabine as salvage therapy in ACC.

METHODS:

Patients registered with the German ACC Registry with refractory ACC progressing after cytotoxic therapies were offered treatment with bevacizumab (5 mg/kg body weight i.v. every 21 days) and oral capecitabine (950 mg/m(2) twice daily for 14 days followed by 7 days of rest) in 2006-2008. Evaluation of tumour response was performed by imaging according to response evaluation criteria in solid tumours every 12 weeks.

RESULTS:

Ten patients were treated with bevacizumab plus capecitabine. None of them experienced any objective response or stable disease. Two patients had to stop therapy after few weeks due to hand-foot syndrome, and three patients died on progressive disease within 12 weeks. Other adverse events were mild (grade I-II). Median survival after treatment initiation was 124 days.

CONCLUSIONS:

Bevacizumab plus capecitabine has no activity in patients with very advanced ACC. Hence, this regimen cannot be recommended as a salvage therapy.

PMID:
19903796
DOI:
10.1530/EJE-09-0804
[Indexed for MEDLINE]

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