Retrospective Cohort Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Feb 24, 2019; 10(2): 75-85
Published online Feb 24, 2019. doi: 10.5306/wjco.v10.i2.75
Retrospective evaluation of FOLFIRI3 alone or in combination with bevacizumab or aflibercept in metastatic colorectal cancer
Madeline Devaux, Laura Gerard, Corentin Richard, Leila Bengrine-Lefevre, Julie Vincent, Antonin Schmitt, François Ghiringhelli
Madeline Devaux, Laura Gerard, Leila Bengrine-Lefevre, Julie Vincent, Antonin Schmitt, François Ghiringhelli, Department of Medical Oncology, Centre George François Leclerc, Dijon 21000, France
Corentin Richard, François Ghiringhelli, Platform of Transfer in Biological Oncology, Centre George François Leclerc, Dijon 21000, France
Author contributions: Devaux M, Gerard L, Bengrine-Lefevre L and Vincent J contributed to data acquisition; Ghiringhelli F and Richard C contributed to data interpretation; Richard C contributed to statistical analyses; Ghiringhelli F and Richard C contributed to manuscript drafting; all authors contributed to manuscript revision and final approval.
Institutional review board statement: The database was declared to the National French Commission for bioinformatics data and patient liberty (CNIL). The study was performed in accordance with French regulations with approval from the local institutional review boards.
Informed consent statement: A general informed consent was signed by all cancer patients at the time of their first hospitalization in the cancer centre. This consent allows the use of their clinical and biological data in the cohort study.
Conflict-of-interest statement: The authors declare that they have no competing interests.
STROBE statement: The STROBE Statement has been adopted.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: François Ghiringhelli, MD, Professor, Department of Medical Oncology, Centre George François Leclerc, 1 Rue du Professeur Marion, Dijon 21000, France. fghiringhelli@cgfl.fr
Telephone: +33-380-732424 Fax: +33-380-737500
Received: October 17, 2018
Peer-review started: October 17, 2018
First decision: November 27, 2018
Revised: December 31, 2018
Accepted: January 23, 2019
Article in press: January 23, 2019
Published online: February 24, 2019
ARTICLE HIGHLIGHTS
Research background

FOLFIRI3 is a modification of the classical FOLFIRI regimen with injection of irinotecan at day 1 and 3. This treatment is used as second or further line in many French Centre’s based of previous retrospective data. This chemotherapeutic regimen could be used alone or in combination with antiangiogenic agent but comparison of efficacy of FOLFIRI3, FOLFIRI3 bevacizumab and FOLFIRI3 aflibercept has never been performed.

Research motivation

Our objective was to compared efficacy and toxicity of FOLFIRI3, FOLFIRI3 bevacizumab and FOLFIRI3 aflibercept regimen.

Research objectives

The main objective of the study is to evaluate the safety and efficacy of the FOLFIRI3-used alone or in combination with bevaicuzmab or aflibercept.

Research methods

This is a monocentric retrospective study evaluating the efficacy and safety of the FOLFIRI3 regimen given alone or in combination with bevacizumab or aflibercept in patients with previously treated metastatic colorectal cancer (mCRC).

Research results

One hundred and fifty-three consecutive patients were included (18 treated with FOLFIRI3, 99 with FOLFIRI3 plus bevacizumab and 36 with FOLFIRI3 plus aflibercept). Median progression-free survival (PFS) and overall survival (OS) were 3.9 mo (95%CI: 3.2-4.9) and 9.4 mo (95%CI: 6.6-12), respectively. Median PFS and OS values were improved in the FOLFIRI3 plus aflibercept group. Grade 3-4 adverse events (diarrhoea and neutropenia) were more frequent in the FOLFIRI3 plus aflibercept group.

Research conclusions

The modification of FOLFIRI regimen had an impacton mCRC patients’ treatment response. The addition of an antiangiogenic agent, in particular aflibercept, enhanced the clinical benefit and improved survival.

Research perspectives

Prospective randomized trial comparing FOLFIRI-aflibercept to FOLFIRI3-aflibercept are warranted.