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Retrospective analysis on the efficacy of bevacizumab with FOLFOX as a first‐line treatment in J apanese patients with metastatic colorectal cancer
Author(s) -
Suenaga Mitsukuni,
Mizunuma Nobuyuki,
Matsusaka Satoshi,
Shinozaki Eiji,
Ueno Masashi,
Yamaguchi Toshiharu
Publication year - 2014
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.12094
Subject(s) - oxaliplatin , folinic acid , bevacizumab , medicine , fluorouracil , regimen , colorectal cancer , folfox , retrospective cohort study , gastroenterology , oncology , progression free survival , chemotherapy , surgery , cancer
Aims Past reports have suggested that the addition of bevacizumab ( BV ) to oxaliplatin combined with 5‐fluorouracil (5‐FU) and folinic acid (leucovorin) ( FOLFOX4 ) provides a limited survival benefit in metastatic colorectal cancer ( mCRC ). Our study aimed to evaluate the survival benefits of a FOLFOX4 + BV regimen. Methods Patients with mCRC who started treatment between A pril 2005 and J uly 2008 were evaluated in this retrospective cohort study. Patients received FOLFOX4 , or FOLFOX4 + BV after the approval of BV in 2007. The two cohorts treated before and after BV approval were compared. Primary end‐points were progression‐free survival ( PFS ), overall survival ( OS ) and response rate ( RR ). Results A total of 213 patients received either FOLFOX4 ( n = 128) or FOLFOX4 + BV ( n = 85). For FOLFOX4 and FOLFOX4 + BV respectively, median PFS was 9.9 and 17.0 months ( HR , 0.58; 95% CI , 0.42–0.82; P = 0.002), median OS was 20.5 and 38.8 months ( HR , 0.49; 95% CI , 0.34–0.71; P < 0.001), respectively. Patients who received 5‐fluorouracil plus leucovorin ( FL ) as maintenance therapy during oxaliplatin suspension in both FOLFOX4 ( n = 6) and FOLFOX4 + BV ( n = 46) groups showed a trend to improved median PFS and median OS . Conclusions The additive effect and potential survival benefits of adding BV to the FOLFOX4 regimen in first‐line treatment of mCRC were demonstrated. Maintenance FL during suspension of oxaliplatin appeared to be an important factor in better survival.