A randomized phase II study of capecitabine-based chemoradiation with or without bevacizumab in resectable locally advanced rectal cancer: clinical and biological features
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- 作者：Ramon Salazar ; Jaume Capdevila ; Berta Laquente ; Jose Luis Manzano…
- 关键词：Bevacizumab ; Chemoradiotherapy ; Locally ; advanced ; Rectal cancer ; Resectable
- 刊名：BMC Cancer
- 出版年：2015
- 出版时间：December 2015
- 年：2015
- 卷：15
- 期：1
- 全文大小：553 KB
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文摘
Background Perioperatory chemoradiotherapy (CRT) improves local control and survival in patients with locally advanced rectal cancer (LARC). The objective of the current study was to evaluate the addition of bevacizumab (BEV) to preoperative capecitabine (CAP)-based CRT in LARC, and to explore biomarkers for downstaging. Methods Patients (pts) were randomized to receive 5?weeks of radiotherapy 45?Gy/25 fractions with concurrent CAP 825?mg/m2 twice daily 5?days per week and BEV 5?mg/kg once every 2?weeks (3 doses) (arm A), or the same schedule without BEV (arm B). The primary end point was pathologic complete response (ypCR: ypT0N0). Results Ninety pts were included in arm A (44) or arm B (46). Grade 3- treatment-related toxicity rates were 16% and 13%, respectively. All patients but one (arm A) proceeded to surgery. The ypCR rate was 16% in arm A and 11% in arm B (p =0.54). Fifty-nine percent vs 39% of pts achieved T-downstaging (arm A vs arm B; p =0.04). Serial samples for biomarker analyses were obtained for 50 out of 90 randomized pts (arm A/B: 22/28). Plasma angiopoietin-2 (Ang-2) levels decreased in arm A and increased in arm B (p p =0.02). Conclusions The addition of BEV to CAP-based preoperative CRT has shown to be feasible in LARC. The association between decreasing Ang-2 levels and tumor downstaging should be further validated in customized studies. Trial registry Clinicaltrials.gov identifier NCT01043484. Trial registration date: 12/30/2009.