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Monoclonal Antibody Infusion

Bevacizumab (Avastin®)
Bevacizumav was first FDA approved to treat advanced CRC when used in combination with a chemotherapy regimen called IFL. Subsequently, in light of studies showing superior efficacy and tolerability compared with IFL, another chemotherapy regimen, FOLFIRIa, became the preferred irinotecan-based regimen to use with bevacizumab.

More recently, two large clinical trials showed that bevacizumab also prolongs the time patients live without their disease getting worse—called progression-free survival (PFS)—when added to platinum-based chemotherapy. The first study in relapsed CRC showed that the addition of bevacizumab to FOLFOX4b chemotherapy increased median PFS by about 2.5 months.2 In the second study, patients received either FOLFOX4 or XELOXc plus BV or placebo.3

While the addition of bevacizumab to the platinum-based regimens improved PFS, a substantial proportion of patients developed nerve toxicity from the platinum chemotherapy and dropped out of the study. For patients who remained on treatment, there was a continued PFS benefit in the bevacizumab arm: 10.4 months for bevacizumab plus chemotherapy compared with 7.9 months for chemotherapy plus placebo.

A third study, called an observational study because it followed actual patients in the clinic, looked at how well bevacizumab worked with a number of different chemotherapy regimens.4 Notably, this study reported a median overall survival of more than 2 years, the longest survival time shown to date in any large study in advanced CRC.


a FOLFIRI = infusional 5-FU plus leucovorin plus irinotecan
b FOLFOX4 = oxaliplatin plus 5-FU plus leucovorin
c XELOX (CAPOX) = capecitabine plus oxaliplatin


Last updated May 29, 2011