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- Title
A Phase II Study of Capecitabine, Oxaliplatin, and Bevacizumab in the Treatment of Metastatic Esophagogastric Adenocarcinomas.
- Authors
Uronis, Hope E.; Bendell, Johanna C.; Altomare, Ivy; Blobe, Gerard C.; Hsu, S. David; Morse, Michael A.; Pang, Herbert; Zafar, S. Yousuf; Conkling, Paul; Favaro, Justin; Arrowood, Christy C.; Cushman, Stephanie M.; Meadows, Kellen L.; Brady, John C.; Nixon, Andrew B.; Hurwitz, Herbert I.
- Abstract
Background. Esophageal and gastric cancers often present at an advanced stage. Systemic chemotherapy is the mainstay of treatment, but survival with current regimens remains poor. We evaluated the safety, tolerability, and efficacy of the combination capecitabine, oxaliplatin, and bevacizumab in the treatment of metastatic esophagogastric adenocarcinomas. Methods. Thirty-seven patients with metastatic or unresectable gastric/gastroesophageal junction tumors were enrolled and treated with capecitabine 850 mg/m2 BID on days 1-14, and oxaliplatin 130mg/m2 with bevacizumab 15 mg/kg on day 1 of a 21- day cycle. The primary endpoint was progression-free survival (PFS). Secondary endpoints included response rate (RR) and overall survival (OS). Neuropilin-1 (NRP1) and -2 (NRP2)mRNA expression was evaluated in archived tumor. Results. Thirty-five patientswereevaluable for efficacy.MedianPFS was 7.2 months; median OS was 10.8 months. RR was estimated at 51.4%. The regimen was tolerable with expected drug class-related toxicities. NRP2 mRNA levels significantly correlated with PFS (p= 0.042) and showed a trend toward significance with OS (p=0.051). Non significant trends for NRP1were noted for higher expression levels and worse outcome. Conclusions. Bevacizumab can be given safely with chemotherapy in patients with metastatic esophagogastric adenocarcinomas. The combination of capecitabine, oxaliplatin,plus bevacizumabhas activity comparable to other bevacizumab-containing regimens in metastatic gastroesophageal cancer.
- Subjects
ANTINEOPLASTIC agents; THERAPEUTIC use of monoclonal antibodies; ADENOCARCINOMA; ANTIMETABOLITES; CANCER chemotherapy; CLINICAL trials; CONFIDENCE intervals; DRUG toxicity; ESOPHAGEAL tumors; METASTASIS; STOMACH tumors; SURVIVAL analysis (Biometry); OXALIPLATIN; BEVACIZUMAB; DESCRIPTIVE statistics; KAPLAN-Meier estimator
- Publication
Oncologist, 2013, Vol 18, Issue 3, p271
- ISSN
1083-7159
- Publication type
Article
- DOI
10.1634/theoncologist.2012-0404