title: XELIRI regimen plus continuous treatment with bevacizumab is well-tolerated and effective in metastatic colorectal cancer patients in a second-line setting involving the sequential administration of XELOX and XELIRI.
abstract: The aim of the present study was to present a retrospective review of 42 metastatic colorectal cancer (mCRC) patients treated using the XELIRI regimen as second-line chemotherapy during the period between 2010 and 2012. Patients were treated with capecitabine, 1,600 (≥65 years) or 2,000 mg/m2(<65 years), on days 1-15, 200 mg/m2irinotecan (CPT-11) on day 1, with or without 7.5 mg/kg bevacizumab on day 1 and every 21 days. A total of 21 patients underwent XELIRI and 21 underwent XELIRI plus bevacizumab treatment. Fifteen patients received continuous administration of bevacizumab in the first- and second-line settings [bevacizumab beyond progression (BBP)+], whereas 27 patients did not receive the treatment (BBP-). Forty patients (95.2%), including all the patients in the BBP+ group, received sequentially administered XELOX and XELIRI regimens from the first- to the second-line setting. The disease control rate (DCR), progression-free survival (PFS), overall survival (OS) and adverse events were compared between the BBP- and BBP+ groups. The median relative dose intensity was similar (93.9% for capecitabine and 96.3% for CPT-11 in the BBP- group vs. 94.8% for capecitabine and 91.5% for CPT-11 in the BBP+ group). The DCR was 25.9% in the BBP- and 66.6% in the BBP+ groups (P=0.020). The median PFS was 3.5 months in the BBP- and 7.2 months in the BBP+ groups (P=0.028). The BBP+ group exhibited a higher median OS time compared to the BBP- group (12.5 months in the BBP- group vs. not reached in the BBP+ group; P=0.0267). The most common grade 3/4 adverse event (n≥20) was hypertension observed in the BBP+ group [three patients (20%)]: these three patients were well-controlled with a single antihypertensive drug. Treatment with sequentially administered XELOX and XELIRI regimens did not aggravate adverse events in the 40 patients. The results showed that the XELIRI regimen, involving continuous treatment with bevacizumab, was well-tolerated and effective as a second-line chemotherapy and sequentially administering XELOX and XELIRI was feasible and manageable for patients with mCRC.
authors: Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan.
authors: Koichi
authors: K
authors: Suzuki
authors: Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan.
authors: Kato
authors: K
authors: Takaharu
authors: Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan.
authors: Yuta
authors: Y
authors: Muto
authors: Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan.
authors: Kosuke
authors: K
authors: Ichida
authors: Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan.
authors: Taro
authors: T
authors: Fukui
authors: Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan.
authors: Yuji
authors: Y
authors: Takayama
authors: Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan.
authors: Shingo
authors: S
authors: Tsujinaka
authors: Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan.
authors: Junichi
authors: J
authors: Sasaki
authors: Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan.
authors: Hisanaga
authors: H
authors: Horie
authors: Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan.
authors: Yutaka J
authors: YJ
authors: Kawamura
authors: Nerima-Hikarigaoka Hospital, Tokyo 179-0072, Japan.
authors: Fumio
authors: F
authors: Konishi
authors: Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan.
authors: Toshiki
authors: T
authors: Rikiyama
keywords: XELIRI; XELOX; bevacizumab; capecitabine; irinotecan; metastatic colorectal cancer