Bevacizumab is a monoclonal antibody against vascular endothelial growth factor. It has shown promising preclinical and clinical activity against metastatic colorectal cancer.
In this study, physicians from the United States evaluated 813 patients with previously untreated metastatic colorectal cancer.
They randomly assigned 402 of the patients to receive irinotecan, bolus fluorouracil, and leucovorin (IFL) plus bevacizumab (5 mg per kilogram of body weight every 2 weeks). The remaining 411 patients received IFL plus placebo.
The physicians measured overall patient survival. They also evaluated progression-free survival, the response rate, the duration of the response, safety, and the quality of life.
|Median length of survival:|
- Bevacizumab group = 20.3 months
- Placebo = 15.6 months
|New England Journal of Medicine|
The team found that the median duration of survival was 20.3 months in the IFL plus bevacizumab group, compared to 15.6 months in the IFL plus placebo group.
Furthermore, the median duration of progression-free survival was 10.6 months in the IFL plus bevacizumab group, compared to 6.2 months in the IFL plus placebo group.
The physicians also found that the median duration of the response was 10.4 months in the IFL plus bevacizumab group, compared to 7.1 months in the IFL plus placebo group.
However, grade 3 hypertension was more common during treatment with IFL plus bevacizumab.
Dr Herbert Hurwitz and colleagues concluded, “The addition of bevacizumab to fluorouracil-based combination chemotherapy results in statistically significant and clinically meaningful improvement in survival among patients with metastatic colorectal cancer“.