Low dose weekly Irinotecan plus Bevacizumab as first line chemotherapy for metastatic colorectal cancer with poor Performance Status ECOG 3 and 4

rachid tanz; tarik mahfoud; Mohamed Reda khmamouch; ilyas el alami; choukri el mhadi; aziz bazine; hassan errihani; mohamed ichou

Volume : VII, Issue : IV, April - 2018

Low dose weekly Irinotecan plus Bevacizumab as first line chemotherapy for metastatic colorectal cancer with poor Performance Status ECOG 3 and 4

Rachid Tanz, Tarik Mahfoud, Mohamed Reda Khmamouch, Ilyas El Alami, Choukri El Mhadi, Aziz Bazine, Hassan Errihani, Mohamed Ichou

Abstract :

Background

Colorectal cancer is the most frequent digestive cancer. Use of chemotherapy and targeted therapy had clearly improved prognostic of metastatic disease. However there are no standard of care for management of patients with poor performance status who are generally excluded from pivotal trials. We conducted this study with the aim to evaluate efficacy and toxicity of low dose weekly Irinotecan plus Bevacizumab regimen in this setting.

Material and methods:

This was a retrospective observational study conducted in medical oncology unit of military hospital Mohamed V of Rabat between January 2010 and December 2014. The study was conducted in patients with mCRC and poor performance status ECOG 3 and 4.

The primary objective was to assess the safety and the efficacy low dose weekly Irinotecan plus Bevacizumab in patients with PS 3 or 4 who received this combination in first–line treatment of mCRC.

Assessment of tumor response was granted by comparative measurement of target lesion size as RECIST1.1 criteria. Treatment was administered until evidence of disease progression, unacceptable toxicity, death or patient refusal.Adverse events were graded according to classification of the National Cancer Institute Common Toxicity Criteria version 4.0.

Results

Between 1 January 2010 and 31 December 2014, eleven patients were included in this study. Therapeutic evaluation showed a rate of disease control of 72.72%, with 27.27% of partial response and 45.45% with stabilization. The median of overall survival of our patients was 7 mouth. No complete response could be obtained. No grade 3/4 toxicities were noted in our patients. Most common adverse events were Diarrhea, Fatigue and hematological toxicities.

Conclusions

Despite the low statistical power of our study, the use of low dose weekly Irinotecan plus Bevacizumabin poor performancemCRC patients seems to be effectiveand well tolerated in this setting and its place deserves tobe studied in a larger study.