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Open Access Research article

Bevacizumab with 5-fluorouracil, leucovorin, and oxaliplatin versus bevacizumab with capecitabine and oxaliplatin for metastatic colorectal carcinoma: results of a large registry-based cohort analysis

Tomas Buchler1*, Tomas Pavlik2, Bohuslav Melichar3, Zbynek Bortlicek2, Zuzana Usiakova4, Ladislav Dusek2, Igor Kiss5, Milan Kohoutek6, Vera Benesova7, Rostislav Vyzula5, Jitka Abrahamova1 and Radka Obermannova5

Author Affiliations

1 Department of Oncology and First Faculty of Medicine, Charles University and Thomayer Hospital, Videnska 800, Prague 140 59, Czech Republic

2 Institute of Biostatistics and Analyses, Masaryk University, Kamenice 126/3, Brno 625 00, Czech Republic

3 Department of Oncology, Palacky University Medical School and Teaching Hospital, I.P.Pavlova 6, Olomouc 775 20, Czech Republic

4 Department of Oncology and First Faculty of Medicine, Charles University and General University Hospital, U nemocnice 2, Prague 128 08, Czech Republic

5 Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Zluty kopec 7, Brno 656 53, Czech Republic

6 Centre for Oncology, Tomas Bata Hospital, Havlickovo nabrezi 600, Zlin 762 75, Czech Republic

7 Department of Oncology, Jihlava Hospital, Vrchlickeho 59, Jihlava 586 33, Czech Republic

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BMC Cancer 2014, 14:323  doi:10.1186/1471-2407-14-323

Published: 7 May 2014

Abstract

Background

Data from the Czech national registry were analysed retrospectively to describe treatment outcomes for capecitabine and oxaliplatin (XELOX) regimen with bevacizumab versus 5-fluorouracil, leucovorin, and oxaliplatin (FOLFOX) regimen with bevacizumab in the first-line therapy for metastatic colorectal cancer (mCRC).

Methods

A national registry containing anonymised individual data on patients treated with targeted therapies was used as a data source. In total, 2,191 mCRC patients who received a first-line therapy with bevacizumab combined with either FOLFOX regimen (n = 1,218, 55.6%) or XELOX regimen (n = 973, 44.4%) were included in the present analysis.

Results

No statistically significant difference in survival was observed between the two groups, with median overall survival (OS) of 27.0 months (95% confidence interval [CI] 24.6-29.5 months) and 30.6 months (95% CI 27.8-33.4 months) for FOLFOX/bevacizumab and XELOX/bevacizumab, respectively (p = 0.281). Median progression-free survival (PFS) was 11.4 months (95% CI 10.7-12.1 months) for FOLFOX/bevacizumab and 11.5 months (95% CI 10.8-12.3 months) for XELOX/bevacizumab (p = 0.337). The number of metastatic sites was identified as the most significant predictor of PFS and, together with the presence/absence of metastatic disease at diagnosis, also for OS.

Conclusions

According to this large registry-based analysis, XELOX and FOLFOX regimens have similar effectiveness for use in combination with bevacizumab in the first-line treatment of mCRC. Multiple metastatic sites and the presence of metastatic disease at diagnosis were the strongest negative predictors of OS regardless of backbone chemotherapy regimen.

Keywords:
Colorectal cancer; Bevacizumab; Capecitabine; 5-fluorouracil; Oxaliplatin