FOLFIRI+bevacizumab induction chemotherapy followed by bevacizumab or observation in metastatic colorectal cancer, a phase III trial (PRODIGE 9 – FFCD 0802)

摘要: During the last 15 years, treatment of patients with metastatic olorectal cancer (mCRC) has undergone major improvements. irst-line combination regimen 5-fluorouracil and rinotecan (FOLFIRI) was associated a significant increase in verall survival [1]. The addition biological agents to chemotherpy, such as anti-vascular endothelial growth factor nti-epidermal receptor monoclonal antibodies evacizumab cetuximab [2,3] increased compared o chemotherapy alone. duration first-line hemotherapy been questioned because toxicities during ong treatments, negative impact on patient quality life. hree phase III studies evaluating sequential (firstine fluoropyrimidine monotherapy followed by second-line dual case progressive disease) revealed no dvantage [4–6]. Therefore, step-up” strategy became an option mCRC but never valuated regimens including agents. To avoid toxicities, concept chemotherapy-free intervals CFIs) “top-down” proposed different 7,8]. In study Labianca et al., experimental arm epetition sequences consisting 2 months FOLFIRI folowed without chemotherapy, even absence f tumour progression [8]: overall same comared continuous chemotherapy. OPTIMOX I study, re-introduced only progresion based baseline status, this less efficient han [7]. Further these two trials, lternative therapy is re-introduction soon s detected, i.e. assessment uring chemotherapy; could allow longer