A Phase II Study of Dose-reductive XELOX Plus Bevacizumab in Elderly or Vulnerable Patients With Metastatic Colorectal Cancer (MCSGO-1202)

Anticancer Res. 2022 Apr;42(4):1859-1865. doi: 10.21873/anticanres.15662.

Abstract

Background/aim: This phase II study (MCSGO-1202) aimed to evaluate the initial dose reduction of oxaliplatin in XELOX plus bevacizumab therapy.

Patients and methods: This was a phase II, multicenter, open-label, single-arm, prospective, study conducted at 14 Japanese institutions. The study included patients with metastatic colorectal cancer (mCRC) with performance status (PS) of 1 or 2 who had not undergone chemotherapy. Patients received oxaliplatin (100 mg/m2) plus bevacizumab (7.5 mg/kg) on day 1 and capecitabine (2,000 mg/m2/day) on days 1-14 of a 21-day cycle. The primary endpoint was the objective response rate. The secondary endpoints were progression-free and overall survival, 1-year survival rate, disease control rate, dose intensity, and adverse events.

Results: Between April 2012 and March 2016, 56 patients were enrolled. The median age was 71 years (range=44-85 years), and the majority (90.6%) had a PS of 1. A complete response was observed in three patients (5.7%), partial response in 24 (45.3%), stable disease in 22 (43.4%), and progressive disease in one (1.9%). The median progression-free survival and overall survival were 11.4 and 26.5 months, respectively. The most common grade 3-4 adverse events were leucopenia (15.1%), neutropenia (9.4%), neuropathy (9.4%).

Conclusion: The dose-reduction strategy of oxaliplatin was effective for elderly or vulnerable patients with mCRC.

Keywords: Metastatic colorectal cancer; XELOX therapy; frail patients; oxaliplatin.

Publication types

  • Clinical Trial, Phase II
  • Multicenter Study

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Bevacizumab / administration & dosage
  • Capecitabine / administration & dosage
  • Colorectal Neoplasms* / drug therapy
  • Colorectal Neoplasms* / pathology
  • Deoxycytidine / therapeutic use
  • Disease-Free Survival
  • Drug Tapering*
  • Fluorouracil
  • Humans
  • Organoplatinum Compounds
  • Oxaloacetates
  • Prospective Studies
  • Treatment Outcome

Substances

  • Organoplatinum Compounds
  • Oxaloacetates
  • Deoxycytidine
  • Bevacizumab
  • Capecitabine
  • Fluorouracil

Supplementary concepts

  • XELOX