title: Capecitabine and irinotecan with and without bevacizumab for advanced colorectal cancer patients.
abstract: OBJECTIVE
  To investigate the efficacy and safety of cape-citabine plus irinotecan +/- bevacizumab in advanced or metastatic colorectal cancer patients.
  
  
  METHODS
  Forty six patients with previously untreated, locally-advanced or metastatic colorectal cancer (mCRC) were recruited between 2001-2006 in a prospective open-label phase II trial, in German community-based outpatient clinics. Patients received a standard capecitabine plus irinotecan (CAPIRI) or CAPIRI plus bevacizumab (CAPIRI-BEV) regimen every 3 wk. Dose reductions were mandatory from the first cycle in cases of > grade 2 toxicity. The treatment choice of bevacizumab was at the discretion of the physician. The primary endpoints were response and toxicity and secondary endpoints included progression-free survival and overall survival.
  
  
  RESULTS
  In the CAPIRI group vs the CAPRI-Bev group there were more female than male patients (47% vs 24%), and more patients had colon as the primary tumor site (58.8% vs 48.2%) with fewer patients having sigmoid colon as primary tumor site (5.9% vs 20.7%). Grade 3/4 toxicity was higher with CAPIRI than CAPIRI-Bev: 82% vs 58.6%. Partial response rates were 29.4% and 34.5%, and tumor control rates were 70.6% and 75.9%, respectively. No complete responses were observed. The median progression-free survival was 11.4 mo and 12.8 mo for CAPIRI and CAPIRI-Bev, respectively. The median overall survival for CAPIRI was 15 mo (458 d) and for CAPIRI-Bev 24 mo (733 d). These differences were not statistically different. In the CAPIRI-Bev, group, two patients underwent a full secondary tumor resection after treatment, whereas in the CAPIRI group no cases underwent this procedure.
  
  
  CONCLUSIONS
  Both regimens were well tolerated and offered effective tumor growth control in this outpatient setting. Severe gastrointestinal toxicities and thromboembolic events were rare and if observed were never fatal.
authors.affiliation: 1st Medical Department, Johannes Gutenberg-University, Langenbeckstrasse 1, 55116 Mainz, Germany. moehler@mail.uni-mainz.de
authors.forename: Markus
authors.initials: M
authors.lastname: Moehler
authors.forename: Martin-F
authors.initials: MF
authors.lastname: Sprinzl
authors.forename: Murad
authors.initials: M
authors.lastname: Abdelfattah
authors.forename: Carl-C
authors.initials: CC
authors.lastname: Schimanski
authors.forename: Bernd
authors.initials: B
authors.lastname: Adami
authors.forename: Werner
authors.initials: W
authors.lastname: Godderz
authors.forename: Klaus
authors.initials: K
authors.lastname: Majer
authors.forename: Dimitri
authors.initials: D
authors.lastname: Flieger
authors.forename: Andreas
authors.initials: A
authors.lastname: Teufel
authors.forename: Juergen
authors.initials: J
authors.lastname: Siebler
authors.forename: Thomas
authors.initials: T
authors.lastname: Hoehler
authors.forename: Peter-R
authors.initials: PR
authors.lastname: Galle
authors.forename: Stephan
authors.initials: S
authors.lastname: Kanzler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D000068258:Bevacizumab; D002166:Camptothecin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000628:therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D018572:Disease-Free Survival; D004361:Drug Tolerance; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D003841:Deoxycytidine; D000068258:Bevacizumab; D005472:Fluorouracil; D002166:Camptothecin