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Rectal Cancer treatment details. Biologic therapy. Chemotherapy. New York University Cancer Institute, New York, NY , United States

Survival: 23.7 months
Toxicity Grade: 5
Treatments: Biologic therapy
Drugs: Leucovorin
Country: United States
City/State/Province: New York, NY
Hospital: New York University Cancer Institute
Journal: Link
Date: 7/2008

Patients: This study reports the findings of two studies, one involving 150 patients and the other involving 223 patients, with metastatic colorectal cancer. These patients ranged in age from 31 to 84 and 30 to 85, respectively.

Treatment: Patients were treated with fluorouracil, leucovorin, and oxaliplatin at a standard dose, those drugs at a lower dose and delivered in a slightly different way (bolus infusion), or capecitabine and oxaliplatin. Other patients were treated with one of those three drug combinations plus bevacizumab, a biological therapy. The treatment group without bevacizumab was called TREE-1, and the group with bevacizumab was called TREE-2.

Toxicity: The most common grade 3 and 4 toxicities were diarrhea, nausea, vomiting, and neutropenia. Four patients in the TREE-1 group and six patients in the TREE-2 group died from treatment-related toxicities. These deaths were from dehydration and diarrhea, septic shock, perforated ulcer, peritonitis, intestinal perforation, cerebrovascular problems, arrhythmia. No deaths occurred in the group of patients treated with fluorouracil, leucovorin, and oxaliplatin at a standard dose with or without bevacizumab.

Results: The median overall survival was 18.2 months for patients in the TREE-1 group (chemotherapy alone) and 23.7 months for those in the TREE-2 group (chemotherapy plus bevacizumab).

Support: Researchers doing this study received research money from Sanofi-Aventis and Genentech. Sanofi-Aventis developed/markets oxaliplatin as Eloxatin, and Genentech developed/markets bevacizumab as Avastin.

Correspondence: Dr. Howard S. Hochster

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