Irinotecan and Capecitabine (CAPIRI) Plus Bevacizumab in First-Line Treatment of Metastatic Colorectal Cancer

The purpose of this prospective study was to assess the efficacy and safety of bevacizumab in combination with reduced doses of irinotecan plus capecitabine (CAPIRI regimen), in patients with metastatic colorectal cancer (mCRC), as first-line chemotherapy. A cohort of 120 mCRC consecutive patients was included. The overall response rate was 63.3% (76 patients; 95% confidence interval [CI], 53.97%-71.77%). Median time to progression and overall survival were 15 months (range: 2-49 months; 95% CI: 13.00, 17.00 months) and 22.5 months (range: 4-54 months; 95% CI: 21.00, 27.00 months), respectively. The one year survival rate was 81.5%. CAPIRI-related grade 3/4 adverse events included alopecia (29.2%) and diarrhoea (16.7%), which were manageable. Bevacizumab-related grade 3 hypertension was reported in 2 patients. One patient died due to treatment related adverse event, which was no bevacizumab-related. In conclusion, combination of bevacizumab plus CAPIRI is a feasible treatment which provides a clinical benefit as first-line treatment in chemonaïve patients with mCRC.