title: Predictors of the efficacy of FOLFIRI plus bevacizumab as second-line treatment in metastatic colorectal cancer patients.
abstract: OBJECTIVE
  Fluoropyrimidine-based chemotherapy plus bevacizumab (BV) is the standard treatment for metastatic colorectal cancer (mCRC). The aim of this study was to investigate the efficacy of BV plus FOLFIRI (5-fluorouracil, leucovorin, irinotecan) as second-line treatment in mCRC patients refractory to first-line oxaliplatin-based chemotherapy, and determine potential predictive factors affecting survival.
  
  
  METHODS
  Thirty-four consecutive patients were included in this retrospective study. All patients received FOLFIRI plus 5 mg/kg BV until progression or unmanageable toxicity occurred. Clinical factors and KRAS status were evaluated as potential biomarkers of efficacy.
  
  
  RESULTS
  The overall response was 23.5%. The median progression-free survival (PFS) and time-to-treatment failure (TTF) were 248 and 221 days, respectively. The median overall survival (OS) was 651 days. A univariate analysis revealed that normal thrombin antithrombin complex, alkaline phosphatase, lactate dehydrogenase, and carbohydrate antigen 125 (CA125) levels at baseline were associated with better PFS, TTF, and OS. A multivariate analysis showed that only the CA125 level at baseline was an independent negative predictor of both PFS and OS. KRAS status was not identified as a predictor.
  
  
  CONCLUSIONS
  The results of this study suggest that FOLFIRI plus BV is a viable option in second-line treatment for mCRC refractory to first-line FOLFOX (5-fluorouracil, leucovorin, oxaliplatin) alone, and indicate that CA125 might be a predictive biomarker for the outcome.
authors.affiliation: Department of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
authors.forename: Mitsukuni
authors.initials: M
authors.lastname: Suenaga
authors.forename: Satoshi
authors.initials: S
authors.lastname: Matsusaka
authors.forename: Masashi
authors.initials: M
authors.lastname: Ueno
authors.forename: Noriko
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Eiji
authors.initials: E
authors.lastname: Shinozaki
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Mizunuma
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Kiyohiko
authors.initials: K
authors.lastname: Hatake
mesh_terms: D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D000068258:Bevacizumab; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068258:Bevacizumab; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin