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©The Author(s) 2019.
World J Clin Oncol. Feb 24, 2019; 10(2): 52-61
Published online Feb 24, 2019. doi: 10.5306/wjco.v10.i2.52
Published online Feb 24, 2019. doi: 10.5306/wjco.v10.i2.52
Table 1 Food and Drug Administration-approved antiangiogenic drugs for the treatment of metastatic colorectal cancer
Agent | Class | Target | Indication | Approved for | Recommended dose |
Bevacizumab | Humanized Moab | VEGF-A | First- and second-line | Use in combination with oxaliplatin and irinotecan-based chemotherapy | 5 mg/kg or 10 mg/kg i.v. every 2 wk |
Aflibercept | Fully human Moab | VEGF-A, -B, and PIGF | Second-line | Use in combination with FOLFIRI | 4 mg/kg i.v. every 2 wk |
Ramucirumab | Fully human Moab | The extracellular domain of VEGFR-2 | Second-line | Use in combination with FOLFIRI | 8 mg/kg i.v. every 2 wk |
Regorafenib | Oral multikinase inhibitor | VEGFR-1, -2, and -3 (in addition to RET, KIT, PDGFR, and FGFR | Beyond second-line | Single-use | 160 mg once daily, days 1-21 of 28-d cycle |
Table 2 Randomized clinical studies comparing the efficacy of second-line chemotherapy plus antiangiogenic agent with chemotherapy alone (or plus placebo) in metastatic colorectal cancer
Study | Type of study | The proportion of patients who received prior BEV | Treatment arms (No. of patients) | ORR (%) | mPFS (mo) | HR | mOS (mo) | HR |
BRiTE[16] | Observational cohort | 100% | CT + BEV (642) | NA | 19.2 | 0.49 | 31.8 | 0.48 |
CT alone (531) | NA | 9.5 | 19.9 | |||||
No treatment (253) | NA | 3.6 | 2.05 | 12.6 | ||||
ARIES[17] | Observational cohort | 100% | CT + BEV (438) | NA | 14.4 | 0.84 | NA | |
CT alone (667) | NA | 10.6 | NA | |||||
Cartwright et al[18] | Observational cohort | 100% | CT+ BEV (267) | NA | 14.6 | 0.74 | 27.9 | 0.76 |
CT alone (306) | NA | 10.1 | 21.4 | |||||
ML18147[19] | Phase 3 | 100% | FOLFOX/FOLFIRI + BEV (409) | 5 | 5.7 | 0.68 | 11.2 | 0.81 |
FOLFOX/FOLFIRI + placebo (411) | 4 | 4.1 | 9.8 | |||||
BEBYP[20] | Phase 3 | 100% | FOLFOX/FOLFIRI + BEV (92) | 21 | 6.8 | 0.70 | 15.5 | 0.77 |
FOLFOX/FOLFIRI + placebo (92) | 17 | 5.0 | 14.4 | |||||
VELOUR[27] | Phase 3 | 30% | FOLFIRI + Aflibercept (612) | 19.8 | 6.9 | 0.76 | 13.5 | 0.82 |
FOLFIRI + placebo (614) | 11.1 | 4.7 | 12.0 | |||||
RAISE[37] | Phase 3 | 100% | FOLFIRI + Ramucirumab (536) | 13.4 | 5.7 | 0.79 | 13.3 | 0.84 |
FOLFIRI + placebo (536) | 12.5 | 4.5 | 11.7 |
- Citation: Kanat O, Ertas H. Existing anti-angiogenic therapeutic strategies for patients with metastatic colorectal cancer progressing following first-line bevacizumab-based therapy. World J Clin Oncol 2019; 10(2): 52-61
- URL: https://www.wjgnet.com/2218-4333/full/v10/i2/52.htm
- DOI: https://dx.doi.org/10.5306/wjco.v10.i2.52