Uracil-Tegafur and Oral Leucovorin Combined With Bevacizumab in Elderly Patients (Aged >= 75 Years) With Metastatic Colorectal Cancer: A Multicenter, Phase II Trial (Joint Study of Bevacizumab, Oral Leucovorin, and Uracil-Tegafur in Elderly Patients [J-BLUE] Study)

摘要

In the present phase II trial of 55 elderly patients (aged >= 75 years) with previously untreated metastatic colorectal cancer, we investigated the efficacy and safety of the combination of uracil-tegafur with oral leucovorin (UFT/LV) and bevacizumab. UFT/LV plus bevacizumab resulted in promising efficacy outcomes with mild toxicity and should be validated in future largescale studies of elderly patients. Background: We previously reported that uracil-tegafur with oral leucovorin (UFT/LV) treatment for elderly patients (aged >= 75 years) was well-tolerated in a phase II study. In the present study, the efficacy and safety of a modified (1-week shorter administration period) UFT/LV schedule combined with bevacizumab for a similar population are reported. Patients and Methods: The present study was a single-arm, open-label, multicenter, cooperative group clinical trial. The key eligibility criteria included age >= 75 years, Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1, first-line chemotherapy, measurable lesions, and preserved organ function. Patients received UFT 300 mg/m(2)/d and LV 75 mg/d on days 1 to 21 and intravenous bevacizumab 5 mg/kg on days 1 and 15. Treatment was repeated every 28 days. The primary endpoint was progression-free survival (PFS), and the secondary endpoints were the objective response rate (ORR), overall survival (OS), and safety. Results: Of the 55 patients enrolled from 15 Japanese institutions, 52 eligible patients were evaluated. Their median age was 80 years (range, 75-7 years), and 73% had an ECOG performance status of 0. The median PFS was 8.2 months (95% confidence interval [CI], 6.2-10 months). The ORR was 40% (95% CI, 27%-55%). The median OS was 23 months (95% CI, 12-33 months). The most common grade 3 and 4 treatment-related adverse events were hypertension (12%), fatigue (8%), anemia (8%), nausea (6%), and diarrhea (6%). Treatment-related death occurred in 2 patients. Conclusion: UFT/LV (3 weeks of therapy and 1 week without) combined with biweekly bevacizumab is a tolerable and effective treatment option for elderly patients (aged >= 75 years) with metastatic colorectal cancer.