A multicentre phase II study of capecitabine, oxaliplatin plus bevacizumab as peri-operative treatment for patients with poor risk colorectal liver-only metastases unsuitable for upfront resection.

A multicentre study of capecitabine, oxaliplatin plus bevacizumab as perioperative treatment of patients with poor-risk colorectal liver-only metastases not selected for upfront resection

Authors: Wong, R., Cunningham, D., Barbachano, Y., Saffery, C., Valle, J., Hickish, T., Mudan, S., Brown, G., Khan, A., Wotherspoon, A., Strimpakos, A.S., Thomas, J., Compton, S., Chua, Y.J., Chau, I.

Journal: Annals of Oncology

Publication Date: 01/01/2011

Volume: 22

Issue: 9

Pages: 2042-2048

eISSN: 1569-8041

ISSN: 0923-7534

DOI: 10.1093/annonc/mdq714

Abstract:

Background: Perioperative chemotherapy improves outcome in resectable colorectal liver-only metastasis (CLM). This study aimed to evaluate perioperative CAPOX (capecitabine-oxaliplatin) plus bevacizumab in patients with poorrisk CLM not selected for upfront resection. Patients and methods: Poor-risk CLM was defined as follows: more than four metastases, diameter >5 cm, R0 resection unlikely, inadequate viable liver function if undergoing upfront resection, inability to retain liver vascular supply, or synchronous colorectal primary presentation. Patients underwent baseline computed tomography, magnetic resonance imaging, and/or positron emission tomography (PET) for staging and received neoadjuvant CAPOX plus bevacizumab, with resectability assessed every four cycles. Primary end point was radiological objective response rate (ORR). Results: Forty-six patients were recruited, of which 91% underwent PET to ensure metastases confined to liver. Following neoadjuvant CAPOX plus bevacizumab, the ORR was 78% (95% confidence interval 63% to 89%). This allowed 12 of 30 (40%) patients with initial nonsynchronous unresectable CLM to be converted to resectability. In addition, 10 of 15 (67%) patients with synchronous resectable CLM underwent liver resection, with four additional patients being observed alone due to excellent response to neoadjuvant therapy. No grade 3-4 perioperative complications were seen. Conclusion: Neoadjuvant CAPOX plus bevacizumab resulted in a high response rate for patients with CLMs with poor-risk features not selected for upfront resection and converted 40% of patients to resectability. © The Author 2011. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.

Source: Scopus

A multicentre study of capecitabine, oxaliplatin plus bevacizumab as perioperative treatment of patients with poor-risk colorectal liver-only metastases not selected for upfront resection

Journal: Annals of Oncology

Publication Date: 01/09/2011

Volume: 22

Pages: 2042-2048

eISSN: 1569-8041

ISSN: 0923-7534

DOI: 10.1093/annonc/mdq714

Abstract:

Background: Perioperative chemotherapy improves outcome in resectable colorectal liver-only metastasis (CLM). This study aimed to evaluate perioperative CAPOX (capecitabine-oxaliplatin) plus bevacizumab in patients with poorrisk CLM not selected for upfront resection. Patients and methods: Poor-risk CLM was defined as follows: more than four metastases, diameter >5 cm, R0 resection unlikely, inadequate viable liver function if undergoing upfront resection, inability to retain liver vascular supply, or synchronous colorectal primary presentation. Patients underwent baseline computed tomography, magnetic resonance imaging, and/or positron emission tomography (PET) for staging and received neoadjuvant CAPOX plus bevacizumab, with resectability assessed every four cycles. Primary end point was radiological objective response rate (ORR). Results: Forty-six patients were recruited, of which 91% underwent PET to ensure metastases confined to liver. Following neoadjuvant CAPOX plus bevacizumab, the ORR was 78% (95% confidence interval 63% to 89%). This allowed 12 of 30 (40%) patients with initial nonsynchronous unresectable CLM to be converted to resectability. In addition, 10 of 15 (67%) patients with synchronous resectable CLM underwent liver resection, with four additional patients being observed alone due to excellent response to neoadjuvant therapy. No grade 3-4 perioperative complications were seen. Conclusion: Neoadjuvant CAPOX plus bevacizumab resulted in a high response rate for patients with CLMs with poor-risk features not selected for upfront resection and converted 40% of patients to resectability. © The Author 2011. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.

Source: Scopus

A multicentre study of capecitabine, oxaliplatin plus bevacizumab as perioperative treatment of patients with poor-risk colorectal liver-only metastases not selected for upfront resection.

Authors: Wong, R., Cunningham, D., Barbachano, Y., Saffery, C., Valle, J., Hickish, T., Mudan, S., Brown, G., Khan, A., Wotherspoon, A., Strimpakos, A.S., Thomas, J., Compton, S., Chua, Y.J., Chau, I.

Journal: Ann Oncol

Publication Date: 09/2011

Volume: 22

Issue: 9

Pages: 2042-2048

eISSN: 1569-8041

DOI: 10.1093/annonc/mdq714

Abstract:

BACKGROUND: Perioperative chemotherapy improves outcome in resectable colorectal liver-only metastasis (CLM). This study aimed to evaluate perioperative CAPOX (capecitabine-oxaliplatin) plus bevacizumab in patients with poor-risk CLM not selected for upfront resection. PATIENTS AND METHODS: Poor-risk CLM was defined as follows: more than four metastases, diameter >5 cm, R0 resection unlikely, inadequate viable liver function if undergoing upfront resection, inability to retain liver vascular supply, or synchronous colorectal primary presentation. Patients underwent baseline computed tomography, magnetic resonance imaging, and/or positron emission tomography (PET) for staging and received neoadjuvant CAPOX plus bevacizumab, with resectability assessed every four cycles. Primary end point was radiological objective response rate (ORR). RESULTS: Forty-six patients were recruited, of which 91% underwent PET to ensure metastases confined to liver. Following neoadjuvant CAPOX plus bevacizumab, the ORR was 78% (95% confidence interval 63% to 89%). This allowed 12 of 30 (40%) patients with initial nonsynchronous unresectable CLM to be converted to resectability. In addition, 10 of 15 (67%) patients with synchronous resectable CLM underwent liver resection, with four additional patients being observed alone due to excellent response to neoadjuvant therapy. No grade 3-4 perioperative complications were seen. CONCLUSION: Neoadjuvant CAPOX plus bevacizumab resulted in a high response rate for patients with CLMs with poor-risk features not selected for upfront resection and converted 40% of patients to resectability.

Source: PubMed

A multicentre study of capecitabine, oxaliplatin plus bevacizumab as perioperative treatment of patients with poor-risk colorectal liver-only metastases not selected for upfront resection

Authors: Wong, R., Cunningham, D., Barbachano, Y., Saffery, C., Valle, J., Hickish, T., Mudan, S., Brown, G., Khan, A., Wotherspoon, A., Strimpakos, A.S., Thomas, J., Compton, S., Chua, Y.J., Chau, I.

Journal: ANNALS OF ONCOLOGY

Publication Date: 09/2011

Volume: 22

Issue: 9

Pages: 2042-2048

eISSN: 1569-8041

ISSN: 0923-7534

DOI: 10.1093/annonc/mdq714

Source: Web of Science

Authors: Cunningham, D., Hickish, T.F.

Journal: Journal of Clinical Oncology

Publication Date: 2010

ISSN: 0732-183X

Source: Manual

Preferred by: Tamas Hickish

A multicentre study of capecitabine, oxaliplatin plus bevacizumab as perioperative treatment of patients with poor-risk colorectal liver-only metastases not selected for upfront resection.

Authors: Wong, R., Cunningham, D., Barbachano, Y., Saffery, C., Valle, J., Hickish, T., Mudan, S., Brown, G., Khan, A., Wotherspoon, A., Strimpakos, A.S., Thomas, J., Compton, S., Chua, Y.J., Chau, I.

Journal: Annals of oncology : official journal of the European Society for Medical Oncology

Publication Date: 09/2011

Volume: 22

Issue: 9

Pages: 2042-2048

eISSN: 1569-8041

ISSN: 0923-7534

DOI: 10.1093/annonc/mdq714

Abstract:

Background

Perioperative chemotherapy improves outcome in resectable colorectal liver-only metastasis (CLM). This study aimed to evaluate perioperative CAPOX (capecitabine-oxaliplatin) plus bevacizumab in patients with poor-risk CLM not selected for upfront resection.

Patients and methods

Poor-risk CLM was defined as follows: more than four metastases, diameter >5 cm, R0 resection unlikely, inadequate viable liver function if undergoing upfront resection, inability to retain liver vascular supply, or synchronous colorectal primary presentation. Patients underwent baseline computed tomography, magnetic resonance imaging, and/or positron emission tomography (PET) for staging and received neoadjuvant CAPOX plus bevacizumab, with resectability assessed every four cycles. Primary end point was radiological objective response rate (ORR).

Results

Forty-six patients were recruited, of which 91% underwent PET to ensure metastases confined to liver. Following neoadjuvant CAPOX plus bevacizumab, the ORR was 78% (95% confidence interval 63% to 89%). This allowed 12 of 30 (40%) patients with initial nonsynchronous unresectable CLM to be converted to resectability. In addition, 10 of 15 (67%) patients with synchronous resectable CLM underwent liver resection, with four additional patients being observed alone due to excellent response to neoadjuvant therapy. No grade 3-4 perioperative complications were seen.

Conclusion

Neoadjuvant CAPOX plus bevacizumab resulted in a high response rate for patients with CLMs with poor-risk features not selected for upfront resection and converted 40% of patients to resectability.

Source: Europe PubMed Central