Patients with surgically unresectable metastatic colorectal cancer (CRC) who receive fluorouracil, oxaliplatin, and irinotecan plus bevacizumab (FOLFOXIRI-Bev) can have a significant response with a possibility of surgical conversion, according to an article published in JAMA Oncology.1
Surgical resection is the only potentially curative treatment in patients with CRC, but many patients are unable to undergo resection at presentation.
The review collected data from 11 clinical trials, prospective case series, and retrospective case series that evaluated FOLFOXIRI-Bev for the treatment of unresectable CRC. The primary endpoint was overall resection rate; secondary end points included curative (R0) resection rate, overall response rate (ORR), overall survival (OS), and median progression-free survival (PFS).
The published studies selected by authors enrolled 877 evaluable patients. The pooled ORR was 69% (95% CI, 65%-72%) which translated to an overall surgical conversion rate of 39.1% (95% CI, 26.9%-52.8%). The R0 resection rate was 28.1% (95% CI, 18.1%-40.8%).
Median OS was 30.2 months (95% CI, 18.1%-40.8), and median PFS was 12.4 months (95% CI, 10.0-14.3 months).
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The authors concluded that FOLFOXIRI-Bev is a highly effective treatment demonstrating a high ORR, not only in managing disease progression but in yielding high rates of conversion for patients with unresectable CRC.
- Tomasello G, Petrelli F, Ghidini M, Russo A, Passalacqua R, Barni S. FOLFOXIRI plus bevacizumab as conversion therapy for patients with initially unresectable metastatic colorectal cancer. JAMA Oncol. 2017 Jul 13. doi: 10.1001/jamaoncol.2017.0278 [Epub ahead of print]