Maintenance treatment with capecitabine plus bevacizumab after six cycles of capecitabine, oxaliplatin, and bevacizumab (CAPOX-B) in patients with metastatic colorectal cancer is effective and does not deteriorate quality of life, a recent study published online early in the journal The Lancet has shown.

For this open-label, controlled, multicenter, phase III trial, researchers sought to determine the efficacy of capecitabine plus bevacizumab maintenance therapy compared with observation.

Researchers enrolled 558 previously untreated patients with metastatic colorectal cancer with stable disease or better after induction with six 3-weekly cycles of CAPOX-B and randomly assigned them 1:1 to either the maintenance group or the observation group.

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Results showed that at a median follow-up of 48 months, the median duration to second progression was 11.7 months in the maintenance group compared with 8.5 months in the observation group (HR = 0.67; 95% CI: 0.56-0.81; P < 0.0001).

Researchers found that maintenance treatment was well tolerated, but 23% of patients in the maintenance group experienced hand-foot syndrome. The study also showed no deterioration in global quality of life during maintenance treatment.


  1. Simkens LH, van Tinteren H, May A, et al. Maintenance treatment with capecitabine and bevacizumab in metastatic colorectal cancer (CAIRO3): a phase 3 randomised controlled trial of the Dutch Colorectal Cancer Group.Lancet. 2015. [Epub ahead of print]. doi: 10.1016/S0140–6736(14)62004-3.