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FOLFIRI-BEVACIZUMAB AS SECOND LINE TREATMENT OF COLORECTAL CANCER 

Med Oncol. 2013 Mar;30(1):486. doi: 10.1007/s12032-013-0486-y. Epub 2013 Feb 12.
FOLFIRI + bevacizumab as second-line therapy for metastatic colorectal cancer pretreated with oxaliplatin: a pooled analysis of published trials.Beretta GD, Petrelli F, Stinco S, Cabiddu M, Ghilardi M, Squadroni M, Borgonovo K, Barni S.
Source
Abstract

Medical Oncology Unit, Humanitas Gavazzeni, Bergamo, Italy.

Irinotecan and infusional 5-fluorouracil-based chemotherapy (FOLFIRI) plus bevacizumab (FOLFIRI-B) is one of the most effective treatments of advanced colorectal cancer (CRC). However, this schedule is regarded more extensively as first-line therapy and its efficacy has not been proven in phase III randomised trials in oxaliplatin-pretreated patients. We have performed a systematic review through PubMed and EMBASE, including all prospective and retrospective publications exploring the efficacy of FOLFIRI-B as second-line chemotherapy in advanced CRC patients pretreated with oxaliplatin and not with B. Pooled estimates of the response rates (RR), weighted medians of progression-free survival (PFS), and overall survival (OS) from all FOLFIRI-B-containing arms were calculated. A total of 11 studies (one randomised phase II trial, two phase II trials, two observational studies, two prospective non-randomised collections, and four retrospective case series) were retrieved giving a total of 435 patients. Overall, the pooled RR (n = 11 publications) was 26 %. Median PFS and OS (n = 11 and 10 publications, respectively) were 8.3 and 17.2 months. FOLFIRI-B is a reasonable and effective option for stage IV CRC pretreated with oxaliplatin and not exposed to B during first-line treatment. Its activity seems better than historical FOLFIRI-based second-line trials.