Multicenter phase II study of FOLFIRI plus bevacizumab after discontinuation of oxaliplatin-based regimen for advanced or recurrent colorectal cancer (CR0802)

Abstract

Background: To investigate the efficacy and safety of FOLFIRI plus bevacizumab regimen with irinotecan (180mg/m2) in patients with advanced or recurrent colorectal cancer who were of the wild-type or heterozygous group for UGT1A1*28 and *6 polymorphisms and discontinued to oxaliplatin-based regimen, prospectively. Methods: The study population consisted of patients who had discontinued oxaliplatin-based regimen for any reason. The primary endpoint was the response rate. FOLFIRI and bevacizumab regimen [irinotecan: 180mg/m2, 5-fluorouracil infusion: 2400mg/m2, 5-fluorouracil bolus: 400mg/m2, levofolinate calcium: 200mg/m2, bevacizumab: 5mg/kg] was repeated every 2weeks for up to 24cycles. Results: Ninety-four patients were enrolled; 93 patients were evaluated on safety, 94 patients on efficacy. The response rate was 10.1% (95% confidence interval (CI): 4.7-18.3%). The median time to treatment failure, progression-free survival, and overall survival were 4.1months (95% CI: 2.8-4.8months), 5.4months (95% CI: 4.1-6.2months), and 14.5months (95% CI: 11.8-17.0months), respectively. The treatment-related death was 1.1%, and the early death ≤30days after the last study treatment was 1.1%. The incidence of grade 3 or higher adverse events was 60.2% for neutropenia, 23.7% for leukopenia, 9.7% for diarrhea, 6.5% for anorexia, and 5.4% for fatigue. All these adverse events and other adverse events were controllable. Conclusions: FOLFIRI plus bevacizumab regimen with an initial irinotecan dose of 180mg/m2 exhibited an adequate antitumor effect and was confirmed to be manageable and tolerable in Japanese patients with advanced or recurrent colorectal cancer, who had discontinued oxaliplatin-based regimen. Trial registration: UMIN000001817.