title: Efficacy and tolerability of biweekly bevacizumab, irinotecan, folinic acid and fluorouracil intravenous bolus (BIFF Regimen) in patients with metastatic colorectal cancer: the southern Italy cooperative oncology group experience.
abstract: BACKGROUND
  We have extensively assessed a biweekly regimen of irinotecan plus folinic acid and fluorouracil bolus (IRIFAFU) in metastatic colorectal cancer (MCRC). Here, we report on the safety and activity of BIFF (bevacizumab plus IRIFAFU) regimen in 94 mCRC patients.
  
  
  METHODS
  Bevacizumab 5 mg/kg (1 hour), and irinotecan 180 mg/m(2) (1 hour) were given intravenously on day 1, 6S-folinic acid 250 mg/m(2) (2 hours), and fluorouracil 850 mg/m(2) (bolus) were given intravenously on day 2 every 2 weeks for a median of 9 cycles per patient (range, 1-12), and maintenance bevacizumab alone was delivered in 16 cases.
  
  
  RESULTS
  Grade ≥ 3 hematologic toxicities were neutropenia (50%) and febrile neutropenia (5%). Most common grade 3 nonhematologic side effects were diarrhea (20%), vomiting (7%), nausea (4%), and stomatitis (4%). Severe hypertension (1%) and epistaxis (1%) rarely occurred. Six complete responses and 44 partial responses were registered, giving a response rate of 53% (95% CI, 43%-64%). Median progression-free survival was 11.5 months (95% CI, 9.0-14.0 months). Forty-three (46%) patients eventually died, and the median overall survival was 24.0 months (95% CI, 20.2-27.8 months).
  
  
  CONCLUSIONS
  Bevacizumab appeared to increase the activity of the IRIFAFU regimen without worsening its tolerability. Efficacy of BIFF was comparable with that reported with other bevacizumab plus irinotecan-based combinations.
authors: National Cancer Institute, Naples, Italy. pasqualecomella@libero.it
authors: Pasquale
authors: P
authors: Comella
authors: Bruno
authors: B
authors: Massidda
authors: Donato
authors: D
authors: Natale
authors: Carlo
authors: C
authors: Putzu
authors: Claudia
authors: C
authors: Sandomenico
authors: Gianfranco
authors: G
authors: Filippelli
authors: Sergio
authors: S
authors: Palmeri
authors: Giovanni
authors: G
authors: Condemi
authors: Giacomo
authors: G
authors: Vessia
authors: Giuseppe
authors: G
authors: Barberis
authors: Maria Teresa
authors: MT
authors: Ionta
authors: Salvatore
authors: S
authors: Tafuto
authors: Enrico
authors: E
authors: Barbato