Journal Article

Histopathologic evaluation of liver metastases from colorectal cancer in patients treated with FOLFOXIRI plus bevacizumab

Caparello, C, Masi, G, Falcone, A, Morvillo, M, Salvatore, L, Schirripa, M, Funel, N, Loupakis, F, Pollina, L, Antoniotti, C, Vasile, E, Cremolini, C, Marmorino, F

2013

Overview

Background: The FOLFOXIRI regimen produces a high rate of radiological and histopathological responses. Bevacizumab added to chemotherapy showed an improvement in pathological response and necrosis of colorectal liver metastases (CLMs). FOLFOXIRI plus bevacizumab produced promising early clinical results and is under investigation in several randomised trials, although no data are currently available on its effects on response of CLMs and on liver toxicities. Methods: Starting from 499 patients enrolled in first-line phase II/III trials, we selected on the basis of tissue sample availability 18 patients treated with FOLFOXIRI/XELOXIRI and 24 patients treated with FOLFOXIRI plus bevacizumab who underwent secondary resection of CLMs. The 28 untreated patients who underwent primary resection of CLMs were included as control group. Responses of CLMs and chemotherapy-induced toxicities were assessed. Results: Among the patients, 63% of those treated with FOLFOXIRI plus bevacizumab, as compared with 28% of those treated with only FOLFOXIRI/XELOXIRI, showed a histopathological response ( P= 0.033). In the two groups, 52% and 12.5%, respectively, showed necrosis ⩾50% ( P =0.017). The incidence of liver toxicities was not significantly increased in patients treated with FOLFOXIRI plus bevacizumab. Conclusion: The addition of bevacizumab to FOLFOXIRI produces high rates of pathologic responses and necrosis of CLM without increasing liver toxicity.

• Publisher: Nature Publishing Group UK,Nature Publishing Group
• Subject: 692/699/1503/1607 / 692/699/67/1059/99 / 692/699/67/1504/1885 / 692/700/139/422 / Adult / Aged / Antibodies, Monoclonal, Humanized - administration & dosage / Antineoplastic Combined Chemotherapy Protocols - administration & dosage / Antineoplastic Combined Chemotherapy Protocols - therapeutic use / Bevacizumab / Biological and medical sciences / Biomedical and Life Sciences / Biomedicine / Camptothecin - administration & dosage / Camptothecin - analogs & derivatives / Camptothecin - therapeutic use / Cancer Research / Cancer therapies / Case-Control Studies / Chemotherapy / Clinical Trials, Phase II as Topic - statistics & numerical data / Clinical Trials, Phase III as Topic - statistics & numerical data / Colorectal cancer / Colorectal Neoplasms - drug therapy / Colorectal Neoplasms - epidemiology / Colorectal Neoplasms - pathology / Cytotoxicity / Drug Resistance / Epidemiology / Female / Fluorouracil - administration & dosage / Fluorouracil - therapeutic use / Gastroenterology. Liver. Pancreas. Abdomen / Humans / Leucovorin - administration & dosage / Leucovorin - therapeutic use / Liver / Liver Neoplasms - drug therapy / Liver Neoplasms - epidemiology / Liver Neoplasms - secondary / Male / Medical research / Medical sciences / Metastasis / Middle Aged / Molecular Diagnostics / Molecular Medicine / Multicenter Studies as Topic / Multiple tumors. Solid tumors. Tumors in childhood (general aspects) / Neoadjuvant Therapy / Oncology / Organoplatinum Compounds - administration & dosage / Organoplatinum Compounds - therapeutic use / Pathology / Response rates / Retrospective Studies / Stomach. Duodenum. Small intestine. Colon. Rectum. Anus / Toxicity / Tumors