Multicenter phase II study of biweekly CAPIRI plus bevacizumab as second-line therapy in patients with metastatic colorectal cancer (JSWOG-C3 study)

Nobuaki Suzuki, Shoichi Hazama, Takeshi Nagasaka, Hiroaki Tanioka, Yasuo Iwamoto, Yuji Negoro, Masami Yamauchi, Michiya Kobayashi, Hiroshi Okuda, Noriaki Fujishima, Taku Nishimura, Naoki Yamanaka, Kazuhiro Toyota, Yoshiko Mori, Yuki Nakagami, Mototsugu Shimokawa, Hiroaki Nagano, Masazumi Okajima

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Abstract

Background: Triweekly capecitabine plus irinotecan (CAPIRI) was not a replacement for fluorouracil, leucovorin, and irinotecan (FOLFIRI) in the treatment of metastatic colorectal cancer (mCRC) because of the potential for greater toxicity. Recently, it has reported that mCAPIRI is well tolerated and non-inferior to FOLFIRI. In this study, we conducted a multicenter phase II trial to assess the efficacy and safety of biweekly CAPIRI plus bevacizumab as second-line chemotherapy for mCRC with reduced toxicity and preserved efficacy. Methods: Patients with mCRC who had received prior chemotherapy, including oxaliplatin-based regimens, were eligible for this study. The treatment protocol administered capecitabine at 1000 mg/m2 twice daily from the evening of day 1 to the morning of day 8, intravenous irinotecan at 150 mg/m2 on day 1, and bevacizumab at 10 mg/kg on day 1 every 2 weeks. Primary endpoints for this study were progression-free survival (PFS) and safety. Secondary endpoints were overall survival (OS), time to treatment failure, response rate (RR), and disease control rate (DCR). Results: Fifty-one patients were enrolled in this study. Median PFS was 5.5 months [95% confidence interval (CI) 4.23–7.40 months], and median OS was 13.5 months (95% CI 11.57–20.23 months). The RR was 14.6% (95% CI 6.5–28.4%), and the DCR was 66.7% (95% CI 51.5–79.2%). Hypertension was the most common Grade 3 adverse event (27.5%), followed by neutropenia (17.6%). Only two patients suffered from grade 3 hand–foot syndrome. Conclusions: In mCRC patients, biweekly CAPIRI + bevacizumab appears effective and feasible as a second-line chemotherapy with relatively low toxicities, and has potential as a useful substitute for FOLFIRI + bevacizumab.

Original languageEnglish
Pages (from-to)1223-1230
Number of pages8
JournalInternational Journal of Clinical Oncology
Volume24
Issue number10
DOIs
Publication statusPublished - Oct 1 2019

Keywords

  • Bevacizumab
  • Biweekly
  • CAPIRI
  • Second line
  • mCRC

ASJC Scopus subject areas

  • Surgery
  • Hematology
  • Oncology

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    Suzuki, N., Hazama, S., Nagasaka, T., Tanioka, H., Iwamoto, Y., Negoro, Y., Yamauchi, M., Kobayashi, M., Okuda, H., Fujishima, N., Nishimura, T., Yamanaka, N., Toyota, K., Mori, Y., Nakagami, Y., Shimokawa, M., Nagano, H., & Okajima, M. (2019). Multicenter phase II study of biweekly CAPIRI plus bevacizumab as second-line therapy in patients with metastatic colorectal cancer (JSWOG-C3 study). International Journal of Clinical Oncology, 24(10), 1223-1230. https://doi.org/10.1007/s10147-019-01473-3