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Article

Real-World Outcomes of First-Line FOLFIRI Plus Bevacizumab with Irinotecan Dose Escalation versus FOLFOXIRI Plus Bevacizumab in BRAFV600E-Mutant Metastatic Colorectal Cancer: The Preliminary Data from a Single-Center Observational Study

by
Hsiang-Lin Tsai
1,2,
Ching-Wen Huang
1,2,
Yen-Cheng Chen
1,2,3,
Wei-Chih Su
1,3,4,
Tsung-Kun Chang
1,3,4,
Po-Jung Chen
1,3,
Ching-Chun Li
1,
Yu-Tang Chang
1,2,5 and
Jaw-Yuan Wang
1,2,3,6,7,*
1
Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
2
Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
3
Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
4
Department of Surgery, Faculty of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
5
Division of Pediatric Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
6
Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
7
Center for Cancer Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
*
Author to whom correspondence should be addressed.
Medicina 2023, 59(12), 2108; https://doi.org/10.3390/medicina59122108
Submission received: 16 September 2023 / Revised: 17 November 2023 / Accepted: 21 November 2023 / Published: 1 December 2023
(This article belongs to the Section Oncology)
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Abstract

Background and Objectives: Approximately 5–10% of all patients with metastatic colorectal cancer (mCRC) harbor a BRAFV600E mutation. These patients exhibit distinct metastatic patterns, poor prognosis, and heterogenous survival outcomes. The findings from the TRIBE study indicated that the administration of FOLFOXIRI plus bevacizumab as first-line treatment extended the median duration of overall survival (OS). In this study, we explored the effects of UGT1A1 polymorphism on the outcomes of irinotecan dose escalation versus FOLFOXIRI plus bevacizumab in patients with BRAFV600E-mutant mCRC. Materials and Methods: We retrospectively reviewed the medical records of 25 patients who had received a diagnosis of BRAFV600E-mutant mCRC between October 2015 and August 2022. All patients underwent UGT1A1 genotyping before receiving bevacizumab plus FOLFIRI. The primary end point was progression-free survival (PFS), and secondary endpoints were OS and adverse events (AEs). The two treatment arms were compared in terms of 6-month PFS and 12-month OS. Results: Over a median follow-up duration of 15.0 (interquartile range, 10.0–30.5) months, no significant differences were noted between the treatment arms in severe AEs (SAEs), 6-month PFS, or 12-month OS (all p < 0.05). Regarding AEs, the FOLFIRI plus bevacizumab regimen was associated with a lower incidence of anorexia than was the FOLFOXIRI plus bevacizumab regimen (p = 0.042). Conclusions: Our findings indicate that FOLFIRI plus bevacizumab with irinotecan dose escalation is an effective first-line treatment regimen for patients with BRAFV600E-mutant mCRC. This regimen leads to acceptable clinical outcomes with manageable AEs. However, the effects on survival and safety outcomes could only be speculated, and further studies are needed because of the sample size, the follow-up for the OS evaluation, and the non-uniformity in all the variables considered in the two groups.
Keywords: BRAFV600E mutation; metastatic colorectal cancer; UGT1A1 polymorphism; irinotecan dose escalation; progression-free survival; overall survival BRAFV600E mutation; metastatic colorectal cancer; UGT1A1 polymorphism; irinotecan dose escalation; progression-free survival; overall survival

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MDPI and ACS Style

Tsai, H.-L.; Huang, C.-W.; Chen, Y.-C.; Su, W.-C.; Chang, T.-K.; Chen, P.-J.; Li, C.-C.; Chang, Y.-T.; Wang, J.-Y. Real-World Outcomes of First-Line FOLFIRI Plus Bevacizumab with Irinotecan Dose Escalation versus FOLFOXIRI Plus Bevacizumab in BRAFV600E-Mutant Metastatic Colorectal Cancer: The Preliminary Data from a Single-Center Observational Study. Medicina 2023, 59, 2108. https://doi.org/10.3390/medicina59122108

AMA Style

Tsai H-L, Huang C-W, Chen Y-C, Su W-C, Chang T-K, Chen P-J, Li C-C, Chang Y-T, Wang J-Y. Real-World Outcomes of First-Line FOLFIRI Plus Bevacizumab with Irinotecan Dose Escalation versus FOLFOXIRI Plus Bevacizumab in BRAFV600E-Mutant Metastatic Colorectal Cancer: The Preliminary Data from a Single-Center Observational Study. Medicina. 2023; 59(12):2108. https://doi.org/10.3390/medicina59122108

Chicago/Turabian Style

Tsai, Hsiang-Lin, Ching-Wen Huang, Yen-Cheng Chen, Wei-Chih Su, Tsung-Kun Chang, Po-Jung Chen, Ching-Chun Li, Yu-Tang Chang, and Jaw-Yuan Wang. 2023. "Real-World Outcomes of First-Line FOLFIRI Plus Bevacizumab with Irinotecan Dose Escalation versus FOLFOXIRI Plus Bevacizumab in BRAFV600E-Mutant Metastatic Colorectal Cancer: The Preliminary Data from a Single-Center Observational Study" Medicina 59, no. 12: 2108. https://doi.org/10.3390/medicina59122108

APA Style

Tsai, H.-L., Huang, C.-W., Chen, Y.-C., Su, W.-C., Chang, T.-K., Chen, P.-J., Li, C.-C., Chang, Y.-T., & Wang, J.-Y. (2023). Real-World Outcomes of First-Line FOLFIRI Plus Bevacizumab with Irinotecan Dose Escalation versus FOLFOXIRI Plus Bevacizumab in BRAFV600E-Mutant Metastatic Colorectal Cancer: The Preliminary Data from a Single-Center Observational Study. Medicina, 59(12), 2108. https://doi.org/10.3390/medicina59122108

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