The efficacy and safety of CapeOX plus bevacizumab therapy followed by capecitabine plus bevacizumab maintenance therapy in patients with metastatic colorectal cancer: a multi-center, single-arm, phase II study (CCOG-0902)
Goro Nakayama,
Kiyoshi Ishigure,
Hiroyuki Yokoyama,
Keisuke Uehara,
Hiroshi Kojima,
Akiharu Ishiyama,
Naomi Hayashi,
Nao Takano,
Norifumi Hattori,
Daisuke Kobayashi,
Chie Tanaka,
Masamichi Hayashi,
Mitsuro Kanda,
Suguru Yamada,
Hiroyuki Sugimoto,
Masahiko Koike,
Michitaka Fujiwara,
Tsutomu Fujii,
Kenta Murotani,
Yuichi Ando,
Yasuhiro Kodera
Affiliations
Goro Nakayama
Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine
Kiyoshi Ishigure
Department of Surgery, Konan Kosei Hospital
Hiroyuki Yokoyama
Department of Surgery, Komaki City Hospital
Keisuke Uehara
Department of Surgical Oncology, Nagoya University Graduate School of Medicine
Hiroshi Kojima
Department of Gastroenterological Surgery, Aichi Cancer Center Aichi Hospital
Akiharu Ishiyama
Department of Surgery, Okazaki City Hospital
Naomi Hayashi
Department of Surgery, Tosei Hospital
Nao Takano
Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine
Norifumi Hattori
Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine
Daisuke Kobayashi
Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine
Chie Tanaka
Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine
Masamichi Hayashi
Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine
Mitsuro Kanda
Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine
Suguru Yamada
Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine
Hiroyuki Sugimoto
Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine
Masahiko Koike
Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine
Michitaka Fujiwara
Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine
Tsutomu Fujii
Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine
Kenta Murotani
Division of Biostatistics, Clinical Research Center, Aichi Medical University Hospital
Yuichi Ando
Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital
Yasuhiro Kodera
Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine
Abstract Background The aim of this study was to evaluate the efficacy and safety of CapeOX plus bevacizumab with a planned oxaliplatin stop-and-go strategy in Japanese patients with metastatic colorectal cancer (mCRC). Methods Patients with untreated mCRC were treated with 4 cycles of CapeOX plus bevacizumab therapy, followed by capecitabine plus bevacizumab maintenance therapy. Reintroduction of oxaliplatin was scheduled after 8 cycles of maintenance therapy or upon tumor progression. The primary endpoint was progression-free survival (PFS), and secondary end points included overall survival (OS), objective response rate to each treatment, reintroduction rate of oxaliplatin, frequency of peripheral sensory neuropathy (PSN), and safety. Results The 52 patients who received the protocol treatment were included in the evaluation of efficacy and safety. Median PFS and OS were 12.4 months (95% confidence interval [CI], 10.0–14.8) and 30.6 months (95% CI, 27.6–33.5), respectively. The objective response rates were 55.8% for the initial CapeOX plus bevacizumab therapy, 17.8% for capecitabine plus bevacizumab maintenance therapy, and 31.0% for reintroduced CapeOX plus bevacizumab therapy. The frequency of PSN was 63.5%, including 3.8% of patients with grade 3 PSN. No patients required treatment discontinuation because of PSN during the induction or maintenance therapy. Conclusions CapeOX plus bevacizumab therapy with a planned oxaliplatin stop-and-go strategy is a feasible first-line treatment for Japanese patients with mCRC. Trial registration This trial is registered with the University Hospital Medical Information Network in 15 March 2010 ( UMIN000006478 ).