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Title: A randomized phase II study of capecitabine-based chemoradiation with or without bevacizumab in resectable locally advanced rectal cancer: clinical and biological features
Author: Salazar Soler, Ramón
Capdevila, Jaume
Laquente, Berta
Manzano, Jose Luis
Pericay, Carles
Martínez Villacampa, Mercedes
López López, Carlos
Losa Gaspà, Ferran
Safont, Maria Jose
Gómez, Auxiliadora
Alonso, Vicente
Escudero, Pilar
Gallego, Javier
Sastre, Javier
Grávalos, Cristina
Biondo, Sebastián
Palacios, Amalia
Aranda, Enrique
Keywords: Anticossos monoclonals
Quimioteràpia del càncer
Càncer colorectal
Malalts de càncer
Monoclonal antibodies
Cancer chemotherapy
Colorectal cancer
Cancer patients
Issue Date: 26-Feb-2015
Publisher: BioMed Central
Abstract: 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 3-4 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 <0.05 at all time points). Decrease in Ang-2 levels from baseline to day 57 was significantly associated with tumor downstaging (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.
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It is part of: BMC Cancer, 2015, vol. 15, p. 60
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ISSN: 1471-2407
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (Ciències Clíniques)

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