Devaux M, Gerard L, Richard C, Bengrine-Lefevre L, Vincent J, Schmitt A, Ghiringhelli F. Retrospective evaluation of FOLFIRI3 alone or in combination with bevacizumab or aflibercept in metastatic colorectal cancer. World J Clin Oncol 2019; 10(2): 75-85 [PMID: 30815374 DOI: 10.5306/wjco.v10.i2.75]
Corresponding Author of This Article
François Ghiringhelli, MD, Professor, Department of Medical Oncology, Centre George François Leclerc, 1 Rue du Professeur Marion, Dijon 21000, France. fghiringhelli@cgfl.fr
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Feb 24, 2019; 10(2): 75-85 Published online Feb 24, 2019. doi: 10.5306/wjco.v10.i2.75
Retrospective evaluation of FOLFIRI3 alone or in combination with bevacizumab or aflibercept in metastatic colorectal cancer
Madeline Devaux, Laura Gerard, Corentin Richard, Leila Bengrine-Lefevre, Julie Vincent, Antonin Schmitt, François Ghiringhelli
Madeline Devaux, Laura Gerard, Leila Bengrine-Lefevre, Julie Vincent, Antonin Schmitt, François Ghiringhelli, Department of Medical Oncology, Centre George François Leclerc, Dijon 21000, France
Corentin Richard, François Ghiringhelli, Platform of Transfer in Biological Oncology, Centre George François Leclerc, Dijon 21000, France
Author contributions: Devaux M, Gerard L, Bengrine-Lefevre L and Vincent J contributed to data acquisition; Ghiringhelli F and Richard C contributed to data interpretation; Richard C contributed to statistical analyses; Ghiringhelli F and Richard C contributed to manuscript drafting; all authors contributed to manuscript revision and final approval.
Institutional review board statement: The database was declared to the National French Commission for bioinformatics data and patient liberty (CNIL). The study was performed in accordance with French regulations with approval from the local institutional review boards.
Informed consent statement: A general informed consent was signed by all cancer patients at the time of their first hospitalization in the cancer centre. This consent allows the use of their clinical and biological data in the cohort study.
Conflict-of-interest statement: The authors declare that they have no competing interests.
STROBE statement: The STROBE Statement has been adopted.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: François Ghiringhelli, MD, Professor, Department of Medical Oncology, Centre George François Leclerc, 1 Rue du Professeur Marion, Dijon 21000, France. fghiringhelli@cgfl.fr
Telephone: +33-380-732424 Fax: +33-380-737500
Received: October 17, 2018 Peer-review started: October 17, 2018 First decision: November 27, 2018 Revised: December 31, 2018 Accepted: January 23, 2019 Article in press: January 23, 2019 Published online: February 24, 2019 Processing time: 128 Days and 9 Hours
Abstract
BACKGROUND
The treatment of metastatic colorectal cancer (mCRC) relies of chemotherapy. The efficacy of the standard FOLFIRI-therapy could be improved by a modification of the regimen by splitting the dose of irinotecan on day 1 and day 3 in the FOLFIRI3 regimen.
AIM
To determine safety and efficacy of FOLFIRI3 regimen.
METHODS
This is a monocentric retrospective study evaluating the efficacy and safety of the FOLFIRI3 regimen given alone or in combination with bevacizumab or aflibercept in patients with previously treated mCRC.
RESULTS
One hundred and fifty-three consecutive patients were included (18 treated with FOLFIRI3, 99 with FOLFIRI3 plus bevacizumab and 36 with FOLFIRI3 plus aflibercept). The overall response rate (ORR) and disease control rate were 51% and 62%, respectively. Similar ORRs were observed in all 3 cohorts. Median progression-free survival (PFS) and overall survival (OS) were 3.9 mo (95%CI: 3.2-4.9) and 9.4 mo (95%CI: 6.6-12), respectively. Median PFS and OS values were improved in the FOLFIRI3 plus aflibercept group. The most common grade 3-4 adverse events were diarrhoea (21.6%) and neutropenia (11.8%), and these toxicities were more frequent in the FOLFIRI3 plus aflibercept group. According to the multivariate Cox proportional model, previous surgery of metastasis and aflibercept were associated with outcomes.
CONCLUSION
The modification of the FOLFIRI regimen impacted treatment response of mCRC patients. The addition of an antiangiogenic agent, in particular aflibercept, enhanced the clinical benefit and improved survival.
Core tip: This retrospective study suggests that modified FOLFIRI with injection of irinotecan at day 1 and 3 is interesting for patients with previously treated metastatic colorectal cancer. Surprisingly the efficacy of the FOLFIRI3-aflibercept seems superior the FOLFIRI3 alone or in combination with bevacizumab. Prospective randomized trial comparing FOLFIRI-aflibercept to FOLFIRI3-aflibercept in second line are warranted.
