Bevacizumab Added to the Irinotecan and Capecitabine Combination for Advanced Colorectal Cancer: A Well-tolerated, Active and Convenient Regimen

Abstract

Objectives: The literature data regarding bevacizumab (BEV) administered together with capecitabine (CAP) and irinotecan (IRI) in patients with advanced colorectal cancer (CRC) are limited. The safety and efficacy of the addition of BEV to the IRI and CAP (XELIRI) regimen were retrospectively analyzed and reported. Patients and Methods: Adult patients 18 years or older with advanced CRC, Eastern Cooperative Oncology Group performance status (ECOG PS) ≤2, exposed to ≤1 chemotherapy (CT) regimen not including IRI or CAP, received BEV 7.5 mg/kg and IRI 220 mg/m² both on day 1; CAP 1.8 g/m²/d, d1-14. The treatment was repeated every 21 days up to a total of 8 cycles. Responding or stabilized patients were treated with BEV 7.5 mg/m², administered as maintenance every 21 days until disease progression. Results: Thirty-four patients were treated, the majority (29, 85.3%) in first-line: eighteen (53%) male, 16 (47%) female, and aged 37-83 years (median 69.5). The treatment was moderately tolerated with mainly gastrointestinal complications: hematological, cardiovascular and other toxicities were also recorded, but they were manageable. No treatment-related death was noted. The overall response rate (RR) was 47.1%, while 41.2% of the patients achieved stable disease. Median progression-free survival and overall survival were 8 and 14 months, respectively, with 16% progression-free and 62% alive at 12 months. Conclusion: BEV-XELIRI is effective and well tolerated, leading to disease control in a vast majority of patients with advanced CRC.