Avastin, Eloxatin plus standard therapy prolong CRC cancer survival

The addition of bevacizumab (Avastin) and oxaliplatin (Eloxatin) to standard chemotherapy prolongs survival in patients with colorectal (CRC) cancer, according to the results of two trials presented at the American Society of Clinical Oncology GI meeting being held in Hollywood, Florida.

Dr. Aimery de Gramont, from Hopital Saint Antoine in Paris, reported on outcomes of 2246 patients with locally advanced, completely resected stage II and III colon cancer. All patients were treated with 5-fluorouracil and leucovorin every 2 weeks for 12 weeks, and approximately half were also randomly assigned to treatment with oxaliplatin (FOLFOX4 regimen). After a median follow-up of 4 years, the researchers observed a 24% reduction in the relative risk of relapse in the FOLFOX4 group (p = 0.0008).”There was increased survival in all subsets of patients,” those with stage II or stage III disease, including those with four or more lymph nodes, Dr. de Gramont said at a press conference. “Patients relapsed at a median time of 2 years after they receive treatment, but many who have relapsed are still alive.””The other measure of concern when we have a new treatment is safety, but with FOLFOX4 there was no increase in the amount they deteriorated during treatment.” In fact, Dr. de Gramont pointed out, they found that neuropathy that had developed during treatment partially or completely resolved over time.Dr. Bruce J. Giantonio, at the University of Pennsylvania in Philadelphia, presented outcomes for patients with previously treated advanced metastatic colorectal cancer. Patients were treated with FOLFOX4 alone (n = 289) or FOLFOX4 plus bevacizumab 10 mg/kg (n = 290).”Bevacizumab is a monoclonal antibody that binds vascular endothelial growth factor, which is a very potent mediator of angiogenesis,” Dr. Giantonio told Reuters Health. “It also has been shown to have immunological effects mediated by VEGF, plus it can affect growth of lymphatic vessels, and there is probably influence on other signaling pathways within tumor cells that affect the growth of the cells.”His group found that median survival was increased from 10.7 months to 12.5 months with addition of bevacizumab (hazard ratio 0.74, p = 0.0024).”This is the first time that bevacizumab has been shown to be effective in a second-line setting,” Dr. Giantonio said. These findings “add to existing experience that suggests bevacizumab’s benefit may be independent of the particular chemotherapy given.”There have been other nonrandomized studies where survival was the endpoint, Dr. Giantonio continued, “and every other study to date in colorectal cancer using this drug has shown a clinical benefit.” By moving bevacizumab to a “front-line setting we’re probably going to see substantial advances” in survival.(Source: American Society of Clinical Oncology: Reuters Health: Oncolink: January 2005.)