PMID- 28476845
OWN - NLM
STAT- MEDLINE
DCOM- 20170810
LR  - 20220317
IS  - 1791-7530 (Electronic)
IS  - 0250-7005 (Linking)
VI  - 37
IP  - 5
DP  - 2017 May
TI  - Neoadjuvant Chemotherapy with Capecitabine, Oxaliplatin and Bevacizumab Followed 
      by Concomitant Chemoradiation and Surgical Resection in Locally Advanced Rectal 
      Cancer with High Risk of Recurrence - A Phase II Study.
PG  - 2683-2691
AB  - AIM: To evaluate feasibility and safety of neoadjuvant chemotherapy with 
      capecitabine, oxaliplatin and bevacizumab followed by concomitant standard 
      chemoradiation and surgical resection in patients with high-risk locally advanced 
      rectal cancer. PATIENTS AND METHODS: Magnetic resonance imaging (MRI)-defined 
      high-risk cT3/4 rectal cancer patients were treated with 3 cycles of neoadjuvant 
      chemotherapy with capecitabine (1,000 mg/m(2) twice daily days 1-14, 22-35, 
      43-56), oxaliplatin (130 mg/sqm on days 1, 22, 43) and bevacizumab (7.5 mg/kg on 
      days 1, 22, 43) followed by capecitabine (825 mg/m(2) twice daily on radiotherapy 
      days week 1-4) concomitantly with radiotherapy (1.8 Gy daily up to 45 Gy in 5 
      weeks) and surgical resection by total mesorectal excision. Feasibility, safety, 
      response rate and postoperative morbidity were evaluated. RESULTS: Twenty-five 
      patients were recruited. Median age was 62 years (range=24-78 years) and all 
      patients had Eastern Cooperation Oncology Group (ECOG) performance status 0. From 
      all patients, 79.2% finished neoadjuvant chemotherapy. Twenty patients underwent 
      surgery. Pathologic complete remission rate, R0 resection and T-downstaging were 
      achieved in 25%, 95% and 54.2% of the "intention to treat" (ITT) patients. The 
      most common grade 3 adverse events (AEs) during neoadjuvant chemotherapy were 
      diarrhea (16.6%) and mucositis (12.5%). In one patient, a grade 4 acute renal 
      failure occurred (4.2%). During chemoradiation, skin reactions (5.3%) were the 
      most common grade 3 AEs. Two major perioperative complications required 
      re-intervention. CONCLUSION: Neoadjuvant chemotherapy with bevacizumab, 
      capecitabine and oxaliplatin followed by concomitant standard chemoradiation is 
      feasible in patients with high-risk locally advanced rectal cancer (LARC) and 
      resulted in complete pathologic remission (pCR) rate of 25% and neoadjuvant 
      chemotherapy completion rate of 80%.
CI  - Copyright(c) 2017, International Institute of Anticancer Research (Dr. George J. 
      Delinasios), All rights reserved.
FAU - Eisterer, Wolfgang
AU  - Eisterer W
AD  - Department of Internal Medicine, Klinikum Klagenfurt am Worthersee, Klagenfurt, 
      Austria.
FAU - Piringer, Gudrun
AU  - Piringer G
AD  - Department of Internal Medicine IV, Wels-Grieskirchen Medical Hospital, Wels, 
      Austria gudrun.piringer@hotmail.com.
FAU - DE Vries, Alexander
AU  - DE Vries A
AD  - Department of Radiotherapy and Radio-Oncology, Feldkirch Hospital, Feldkirch, 
      Austria.
FAU - Ofner, Dietmar
AU  - Ofner D
AD  - Department of Visceral-, Transplant and Thoracic Surgery, Center of Operative 
      Medicine, Innsbruck Medical University, Innsbruck, Austria.
FAU - Greil, Richard
AU  - Greil R
AD  - Department of Internal Medicine III, Paracelsus Medical University, Salzburg, 
      Austria.
FAU - Tschmelitsch, Jorg
AU  - Tschmelitsch J
AD  - Department of Surgery, St. Veit Hospital, Sankt Veit an der Glan, Austria.
FAU - Samonigg, Hellmut
AU  - Samonigg H
AD  - Department of Internal Medicine, Medical University, Graz, Austria.
FAU - Solkner, Lidija
AU  - Solkner L
AD  - Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria.
FAU - Gnant, Michael
AU  - Gnant M
AD  - Department of Surgery and Comprehensive Cancer Center, Medical University, 
      Vienna, Austria.
FAU - Thaler, Josef
AU  - Thaler J
AD  - Department of Internal Medicine IV, Wels-Grieskirchen Medical Hospital, Wels, 
      Austria.
CN  - Austrian Breast and Colorectal Cancer Study Group
LA  - eng
PT  - Clinical Trial, Phase II
PT  - Journal Article
PT  - Multicenter Study
PL  - Greece
TA  - Anticancer Res
JT  - Anticancer research
JID - 8102988
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Organoplatinum Compounds)
RN  - 04ZR38536J (Oxaliplatin)
RN  - 2S9ZZM9Q9V (Bevacizumab)
RN  - 6804DJ8Z9U (Capecitabine)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antineoplastic Agents/adverse effects/therapeutic use
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use
MH  - Bevacizumab/adverse effects/*therapeutic use
MH  - Capecitabine/adverse effects/*therapeutic use
MH  - *Chemoradiotherapy/adverse effects
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Neoadjuvant Therapy
MH  - Neoplasm Recurrence, Local
MH  - Organoplatinum Compounds/adverse effects/*therapeutic use
MH  - Oxaliplatin
MH  - Rectal Neoplasms/diagnostic imaging/drug therapy/surgery/*therapy
MH  - Risk
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - Neoadjuvant chemotherapy
OT  - capecitabine
OT  - oxaliplatin and bevacizumab
OT  - rectal cancer
EDAT- 2017/05/10 06:00
MHDA- 2017/08/11 06:00
CRDT- 2017/05/07 06:00
PHST- 2017/03/19 00:00 [received]
PHST- 2017/04/03 00:00 [revised]
PHST- 2017/04/04 00:00 [accepted]
PHST- 2017/05/07 06:00 [entrez]
PHST- 2017/05/10 06:00 [pubmed]
PHST- 2017/08/11 06:00 [medline]
AID - 37/5/2683 [pii]
AID - 10.21873/anticanres.11617 [doi]
PST - ppublish
SO  - Anticancer Res. 2017 May;37(5):2683-2691. doi: 10.21873/anticanres.11617.