Background / Aim. FOLFOX (5fluorouracil, folinic acid, oxaliplatin)/CapOx
(capecitabine, oxaliplatin) plus bevacizumab and FOLFIRI (5 fluorouracil,
folinic acid, irinotecan) plus bevacizumab are a standard treatment options
for a first line treatment of metastatic colorectal carcinoma (mCRC). The
aim of this study was to compare overall response rate (ORR),
progression-free survival (PFS) and overall survival (OS) in the groups of
patients with mCRC who were treated in the first line with FOLFIRI/bev
versus FOLFOX/bev. At the same time, it was compared the safety profile in
observed groups of patients and investigated optimal treatment duration and
characteristics of patients who had the best treatment outcomes. Methods. In
a retrospective-prospective study, patients with mCRC were treated with a
chemotherapy protocols for the first line in combination with bevacizumab
(FOLFOX/bev, respectively, FOLFIRI/bev). Treatment efficacy was evaluated on
the basis of overall response rate (ORR), progression-free survival (PFS)
and overall survival (OS), and the safety of treatment was evaluated by
monitoring adverse drug reactions. Results. ORR was 70% in the FOLFIRI/bev
group and 50% in the FOLFOX/bev group. Median PFS for FOLFIRI/bev (n = 30)
and for FOLFOX/bev (n = 30) was 15.6 months and 12.1 months respectively
(HR, 0.85; 95% confidence interval (CI) 0.47-1.53; P = 0.5591). Median OS
for FOLFIRI/bev and for FOLFOX/bev was 24.7 months and 19.9 months
respectively (HR, 0.67; 95% confidence interval (CI) 0.37-1.23; P = 0.1552).
In both patient groups, the patients who received more than 9 cycles of
induction therapy had better treatment response in comparison with patients
who received less than 9 cycles of therapy. In FOLFOX/bev group PFS was 16.9
versus 9.7 months and OS was 22.1 versus 17.6 months respectively. In
FOLFIRI/bev group PFS was 9 months for patients who received less than 9
cycles of therapy versus 18.8 months for patients who received more than 9
cycles, OS was 18.0 versus 27.7 respectively. The adverse drug reactions
grade 3 and 4 were 7% in the FOLFIRI/bev group versus 27% in the FOLFOX/bev
group. Conclusion. Patients who received FOLFIRI/bev had better ORR (70 %
versus 50 %), PFS (15.6 versus 12.1 months) and OS (24.7 versus 19.9
months). In both patient groups, better treatment response had the patients
who received induction therapy for 4-6 months (more than 9 cycles of
therapy).