Efficacy and Safety of Capecitabine Combined with Bevacizumab or Single Agent of Capecitabine as Maintenance Therapy for Advanced Colorectal Cancer

Jian-ping LI; Xue-ren GAO; Xiao-yan ZHANG; Ping CHEN; Su-rong CHEN; Wei-gang BIAN; Zhi-jun HUANG

doi:10.12259/j.issn.2095-610X.S20210908

Volume 42 Issue 9

Sep. 2021

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Article Navigation > Journal of Kunming Medical University > 2021 > 42(9): 119-126

Jian-ping LI, Xue-ren GAO, Xiao-yan ZHANG, Ping CHEN, Su-rong CHEN, Wei-gang BIAN, Zhi-jun HUANG. Efficacy and Safety of Capecitabine Combined with Bevacizumab or Single Agent of Capecitabine as Maintenance Therapy for Advanced Colorectal Cancer[J]. Journal of Kunming Medical University, 2021, 42(9): 119-126. doi: 10.12259/j.issn.2095-610X.S20210908

Citation:

Jian-ping LI, Xue-ren GAO, Xiao-yan ZHANG, Ping CHEN, Su-rong CHEN, Wei-gang BIAN, Zhi-jun HUANG. Efficacy and Safety of Capecitabine Combined with Bevacizumab or Single Agent of Capecitabine as Maintenance Therapy for Advanced Colorectal Cancer[J]. Journal of Kunming Medical University, 2021, 42(9): 119-126. doi: 10.12259/j.issn.2095-610X.S20210908

Citation:

Jian-ping LI, Xue-ren GAO, Xiao-yan ZHANG, Ping CHEN, Su-rong CHEN, Wei-gang BIAN, Zhi-jun HUANG. Efficacy and Safety of Capecitabine Combined with Bevacizumab or Single Agent of Capecitabine as Maintenance Therapy for Advanced Colorectal Cancer[J]. Journal of Kunming Medical University, 2021, 42(9): 119-126. doi: 10.12259/j.issn.2095-610X.S20210908

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Efficacy and Safety of Capecitabine Combined with Bevacizumab or Single Agent of Capecitabine as Maintenance Therapy for Advanced Colorectal Cancer

doi: 10.12259/j.issn.2095-610X.S20210908

1.
Dept. of Oncology，The Yancheng Clinical College of Xuzhou Medical University，The First People’s Hospital of Yancheng，Yancheng Jiangsu 224006
2.
School of Pharmacy， Yancheng Teachers’ University，Yancheng Jiangsu 224007，China

Received Date: 2021-07-09
Available Online: 2021-09-13
Publish Date: 2021-09-30

Abstract

Abstract

Objective To investigate the efficacy and safety of capecitabine combined with bevacizumab or single agent of capecitabine as the maintenance therapy following the induction of XELOX regimen combined with bevacizumab in the first-line treatment of advanced colorectal cancer. Methods A total of 100 patients with the advanced colorectal cancer were treated with XELOX regimen （oxaliplatin plus capecitabine） combined with bevacizumab as first-line induction therapy for 6 cycles, whose efficacy were evaluated as the complete response, partial response or stable disease. These patients were divided in a 1∶1 ratio into the capecitabine combined with bevacizumab group （n = 50） and the single agent of capecitabine group （n = 50） for the maintenance therapy until the first disease progression or intolerable adverse events. The primary end point was progression-free survival from the initiation of maintenance therapy to the disease progression （PFS₁）. Secondary endpoints were progression-free survival from the initiation of induction therapy to the disease progression （PFS₂）, overall survival （OS） and adverse events. Results One-hundred patients were treated with capecitabine plus bevacizumab （n = 50） or single agent of capecitabine （n = 50） as the maintenance therapy. The median PFS₁, median PFS₂, and median OS of combination group were significantly longer than those of the monotherapy group, which were 9.0 （95% confidence interval （CI） 8.52-9.47） versus 7.2 （6.16-8.24, P < 0.0001） months, 13.5 （12.55-14.45） versus 12.3 （11.21-13.38, P < 0.0001） months and 27.0 （25.31-28.69） versus 26.2 （24.09-28.31, P = 0.011） months, respectively. Subgroup analysis showed that PFS₁ of the combination group was significantly prolonged in the simultaneous metastasis and RAS/BRAF mutant subgroups. OS of the combination group was significantly prolonged in the male and liver metastatic subgroups. Similar treatment-related adverse events were observed in both groups. The most common toxicities both were neutropenia, mucositis, hand-foot syndrome and diarrhea. The incidence of hypertension （20% versus 4%） and proteinuria （14% versus 2%） were higher in the combination group than that in the monotherapy group. Conclusion Both capecitabine combined with the bevacizumab and the single agent of capecitabine can be considered as the appropriate options following the induction of XELOX regimen combined with bevacizumab as the first line treatment for advanced colorectal cancer with good efficacy and acceptable toxicities. Capecitabine combined with bevacizumab as maintenance therapy has a better survival benefit than single agent of capecitabine.
- Advanced colorectal cancer,
- Induction therapy,
- Maintenance therapy,
- Bevacizumab,
- Capecitabine

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References(19)

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