Bevacizumab plus infusional 5-fluorouracil,leucovorin and irinotecan for advanced colorectal cancer that progressed after oxaliplatin and irinotecan chemotherapy:A pilot study

AIM:TO evaluate the combination of bevacizumab with infusional 5-fluorouracil (5-FU),leucovorin (LV) and irinotecan (FOLFIRI) in patients with advanced colorectal cancer (CRC) pretreated with combination regimens including irinotecan and oxaliplatin. METHODS:Fourteen patients (median age 56 years) with advanced CRC,all having progressed after oxaliplatin-and irinotecan-based combination chemotherapy,were enrolled in this study.Patients were treated with 2 h infusion of irinotecan 150 mg/m~2 on d 1,plus bevacizumab 5 mg/kg iv infusion for 90 min on d 2,and iv injection of LV 20 mg/m~2 followed by a bolus of 5-FU 400 mg/m~2 and then 22 h continuous infusion of 600 mg/m~2 given on two consecutive days every 14 d. RESULTS:The median number of cycles of chemotherapy was six (range 3-12).The response rate was 28.5%,one patient had a complete response,and three patients had a partial response.Eight patients had stable disease.The median time to progression was 3.9 mo (95% CI 2.0-8.7), and the median overall survival was 10.9 mo (95% CI 9.6-12.1).Grade 3/4 neutropenia occurred in five patients,and two of these developed neutropenic fever. Grade 3 hematuria and hematochezia occurred in one. Grade 2 proteinuria occurred in two patients.However, hypertension,bowel perforation or thromboembolic events did not occur in a total of 90 cycles. CONCLUSION:Bevacizumab with FOLFIRI is well tolerated and a feasible treatment in patients with heavily treated advanced CRC.