Xeliri Plus Bevacizumab Compared with Folfiri Plus Bevacizumab as First-Line Setting in Patients with Metastatic Colorectal Cancer: Experiences at Two-Institutions

Background: Efficacy of chemotherapy plus bevacizumab has been shown in patients with metastatic colorectalcancer (mCRC) compared with chemotherapy alone. The aim of the present study was to evaluate the efficacyand safety of FOLFIRI or XELIRI regimens in combination with bevacizumab for mCRC patients in a first-linesetting. Materials and
Methods: A total of 132 patients with previously untreated and histologically confirmedmCRC were included. They were treated with either FOLFIRI-Bevacizumab (Bev) or XELIRI-Bev accordingto physician preference. The efficacy and safety of the two regimens were compared.
Results: Between 2006and 2010, 68 patients were treated with the XELIRI-Bev regimen, while the remaining 64 patients received theFOLFIRI-Bev regimen. The median age was 58.5 years (53.6 years in the FOLFIRI-Bev and 59.7 years in theXELIRI-Bev arm, p=0.01). Objective response rate was 51.6% for FOLFIRI-Bev versus 41.2% for XELIRI-Bev(p=0.38). At the median follow-up of 24.5 months, the median progression-free survival (PFS) was not differentbetween two groups (14.2 months in FOLFIRI-Bev vs. not reached in the XELIRI-Bev, p=0.30). However,median overall survival time for the FOLFIRI-Bev arm was better than that for patients treated with XELIRIBev,but these differences was not statistically significant (37.8 months vs. 28.7 months, respectively, p=0.58).Most commonly reported grade 3-4 toxicities (FOLFIRI-Bev vs XELIRI-Bev) were nausea/vomiting (7.8% vs.14.7%, p=0.27), diarrhea (10.9% vs 22.1%, p=0.10), hand-foot syndrome (0% vs 8.8%, p=0.02) and neutropenia(18.7% vs 27.9%, p=0.22).
Conclusion: Our results showed that FOLFIRI-Bev and XELIRI-Bev regimens weresimilarly effective treatments in a first-line setting for patients with untreated mCRC, with manageable adverseevent profiles.