Second-line FOLFIRI plus ramucirumab with or without prior bevacizumab for patients with metastatic colorectal cancer

Cancer Chemother Pharmacol. 2019 Aug;84(2):307-313. doi: 10.1007/s00280-019-03855-w. Epub 2019 May 7.

Abstract

Purpose: Few data of folinic acid, fluorouracil, and irinotecan (FOLFIRI) plus ramucirumab (RAM) obtained in bevacizumab-naïve patients in clinical trials or routine clinical practice are available. The purpose of this retrospective study was to report the results of FOLFIRI plus RAM treatment as second-line chemotherapy for metastatic colorectal cancer (mCRC).

Methods: Seventy-four patients with mCRC who received second-line FOLFIRI + RAM mCRC therapy were stratified by previous first-line therapy to groups that had (PB) or had not (NPB) been given bevacizumab. The overall survival (OS), progression-free survival (PFS), and objective response were evaluated.

Results: The overall median PFS was 6.2 months (95% CI 4.6-9.3) and median OS was 17.0 months (95% CI 11.6-NA). Median PFS was 8.0 months (95% CI 4.9-11.2) in NPB patients and 5.0 months (95% CI 3.1-7.3) in PB patients (hazard ratio = 0.72, 95% CI 0.40-1.30, p = 0.28). The response rates were 23% and 3% in NPB and PB patients, respectively. The disease control rates were 85% and 69% in NPB and PB patients, respectively.

Conclusions: The effectiveness of FOLFIRI + RAM as a second-line chemotherapy in patients with mCRC was in line with that reported in the previous RAISE phase III trial. The response was better in bevacizumab-naïve patients than those with first-line treatment that had included bevacizumab.

Keywords: Anti-VEGF; Bevacizumab-naïve; Colorectal cancer; EGFR; RAM.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal, Humanized / pharmacology
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / pharmacology
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bevacizumab / pharmacology
  • Bevacizumab / therapeutic use*
  • Camptothecin / analogs & derivatives*
  • Camptothecin / pharmacology
  • Camptothecin / therapeutic use
  • Cohort Studies
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / pathology
  • Female
  • Fluorouracil / pharmacology
  • Fluorouracil / therapeutic use
  • Humans
  • Leucovorin / pharmacology
  • Leucovorin / therapeutic use
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Ramucirumab
  • Retrospective Studies

Substances

  • Antibodies, Monoclonal, Humanized
  • Bevacizumab
  • Leucovorin
  • Fluorouracil
  • Camptothecin

Supplementary concepts

  • IFL protocol