Rapid Communication
Copyright ©2007 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 14, 2007; 13(46): 6231-6235
Published online Dec 14, 2007. doi: 10.3748/wjg.v13.i46.6231
Bevacizumab plus infusional 5-fluorouracil, leucovorin and irinotecan for advanced colorectal cancer that progressed after oxaliplatin and irinotecan chemotherapy: A pilot study
Hyuk-Chan Kwon, Sung Yong Oh, Suee Lee, Sung-Hyun Kim, Hyo-Jin Kim
Hyuk-Chan Kwon, Sung Yong Oh, Suee Lee, Sung-Hyun Kim, Hyo-Jin Kim, Departments of Internal Medicine, Dong-A University College of Medicine, Busan 602-715, Korea
Author contributions: All authors contributed equally to the work.
Correspondence to: Hyo-Jin Kim, MD, PhD, Department of Internal Medicine, Dong-A University College of Medicine, 3-1 Dongdaeshin-dong, Seo-gu, Busan 602-715, Korea. kimhj@dau.ac.kr
Telephone: +82-51-2402951 Fax: +82-51-2402088
Received: June 17, 2007
Revised: September 6, 2007
Accepted: October 28, 2007
Published online: December 14, 2007

AIM: To evaluate the combination of bevacizumab with infusional 5-fluorouracil (5-FU), leucovorin (LV) and irinotecan (FOLFIRI) in patients with advanced colorectal cancer (CRC) pretreated with combination regimens including irinotecan and oxaliplatin.

METHODS: Fourteen patients (median age 56 years) with advanced CRC, all having progressed after oxaliplatin- and irinotecan-based combination chemotherapy, were enrolled in this study. Patients were treated with 2 h infusion of irinotecan 150 mg/m2 on d 1, plus bevacizumab 5 mg/kg iv infusion for 90 min on d 2, and iv injection of LV 20 mg/m2 followed by a bolus of 5-FU 400 mg/m2 and then 22 h continuous infusion of 600 mg/m2 given on two consecutive days every 14 d.

RESULTS: The median number of cycles of chemotherapy was six (range 3-12). The response rate was 28.5%, one patient had a complete response, and three patients had a partial response. Eight patients had stable disease. The median time to progression was 3.9 mo (95% CI 2.0-8.7), and the median overall survival was 10.9 mo (95% CI 9.6-12.1). Grade 3/4 neutropenia occurred in five patients, and two of these developed neutropenic fever. Grade 3 hematuria and hematochezia occurred in one. Grade 2 proteinuria occurred in two patients. However, hypertension, bowel perforation or thromboembolic events did not occur in a total of 90 cycles.

CONCLUSION: Bevacizumab with FOLFIRI is well tolerated and a feasible treatment in patients with heavily treated advanced CRC.

Keywords: Bevacizumab, Irinotecan, Leucovorin, 5-fluorouracil, Colorectal cancer