Neoadjuvant capecitabine and oxaliplatin (XELOX) combined with bevacizumab for high-risk localized rectal cancer

Hasegawa, Junichi; Nishimura, Junichi; Mizushima, Tsunekazu; Miyake, Yasuhiro; Kim, Ho Min; Takemoto, Hiroyuki; Tamagawa, Hiroo; Noura, Shingo; Fujii, Makoto; Fujie, Yujiro; Kato, Takeshi; Miwa, Hideaki; Takemasa, Ichiro; Ikeda, Masataka; Yamamoto, Hirofumi; Sekimoto, M.; Nezu, Riichiro; Doki, Yuichiro; Mori, Masaki

doi:10.1007/s00280-014-2417-9

Cited by 64 publications

(47 citation statements)

References 29 publications

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“…In contrast, the current study included all patients with a CRM initially < 2 mm and none of the patients had a cT2 tumour. The extent of the primary tumour and the presence of metastatic disease in most patients probably contributed to the lower chemosensi- [27], preoperative chemotherapy was given to 25 patients with LARC. The authors reported pCR in one (4%) case and a major pathological response in five (20%).…”

Section: Discussionmentioning

confidence: 99%

Pathological response of locally advanced rectal cancer to preoperative chemotherapy without pelvic irradiation

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Pathological response of locally advanced rectal cancer to preoperative chemotherapy without pelvic irradiation

et al. 2015

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“…A total of 32 studies were ultimately included, after ruling out 16 ineligible investigations which failed to meet the inclusion and exclusion criteria for this meta‐analysis. The included studies consisted of 21 for the VEGF inhibitor, bevacizumab , and 11 for EGFR inhibitors (eight for cetuximab , one for nimotuzumab and two for panitumumab ). These included one randomized clinical trial (RCT) and three clinical controlled trials (CCT) , but we only analyzed cohorts which tested the addition of targeted agents to their neoadjuvant therapy regimens for this meta‐analysis.…”

Section: Resultsmentioning

confidence: 99%

The efficacy of adding targeted agents to neoadjuvant therapy for locally advanced rectal cancer patients: a meta‐analysis

Zhong

Gao

et al. 2018

Cancer Medicine

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Patients with locally advanced rectal cancer (LARC) are at tremendous risk of metastatic diseases. To improve the prognoses of LARC patients, the efficacy of adding targeted agents to neoadjuvant therapy has been investigated by many researchers but remains controversial. A literature search of relevant databases was conducted through December 2016, 804 studies were identified and 32 investigations were ultimately included. A total of 1196 patients from 31 cohorts of 29 studies were eligible for quantitative synthesis in this single‐arm setting meta‐analysis. As pathologic complete response (pCR) shows promise as a prognosis indicator, we focused on pCR rates to evaluate whether adding targeted agents to neoadjuvant therapies improves the outcome of LARC patients. In our study, we revealed pooled estimates of pCR of 27% (95%CI, 21–34%) and 14% (95%CI, 9–21%) for bevacizumab‐relevant cohorts and cetuximab‐relevant cohorts, respectively. The safety of adding targeted agents to neoadjuvant therapy was also evaluated by pooling the data of Grade 3/4 toxicity. In conclusion, our study revealed that adding bevacizumab to the neoadjuvant therapy regimens provides appreciable pCR for LARC patients. Meanwhile, the efficacy of cetuximab remains inconclusive, RCTs with larger scale and better study design that stress more on mutational status are needed.

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“…Evaluating the significance of the preoperative use of Bev is a topic for future study [59]. Hasegawa et al investigated the results of a phase II trial using the same regimen [58] and reported a good response rate including a pCR and near-pCR rate of 21.7 %. However, Moreover, there are still many problems to be resolved with regard to the recommended regimens and periods of CTx, and the efficacy of the targeted drugs.…”

Section: Chemotherapy Alonementioning

confidence: 97%

“…Recently, several studies have been performed to evaluate the safety and efficacy of NAC alone, both in Western countries and Japan ( Several trials have been conducted in Japan to evaluate the safety and efficacy of NAC alone for the treatment of high-risk rectal cancer [57,58]. Upfront surgery is the standard Japanese treatment.…”

Section: Chemotherapy Alonementioning

confidence: 99%

Neoadjuvant treatment for locally advanced rectal cancer: a systematic review

Uehara

Nagino

2015

Surg Today

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We reviewed the history and the current status of neoadjuvant treatment for locally advanced rectal cancer (LARC) in Western countries and Japan. The introduction of total mesorectal excision (TME) and preoperative radiotherapy (RT) were treatment revolutions that resulted in improved local control after curative resection for rectal cancer. However, local relapses still occur, even in the era of TME, and remain a cause of recurrence worldwide. The high rate of distant metastasis after curative resection remains a problem. Furthermore, the introduction of newly developed cytotoxic agents into the LARC treatment strategy continues to be an ongoing challenge. Shifting part of an adjuvant chemotherapy (CTx) regimen to the preoperative period is a promising strategy. Currently, various novel methods, such as induction CTx, consolidation CTx, concomitant administration with RT, and neoadjuvant CTx without RT, have been attempted worldwide. Although some strategies have shown favorable short-term outcomes, the long-term efficacy of the treatments needs be evaluated. At the same time, we must investigate clinical and/or molecular biomarkers to predict the therapeutic effects of each treatment, which is the fastest route to providing ideal personalized therapy for patients with LARC.

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Neoadjuvant capecitabine and oxaliplatin (XELOX) combined with bevacizumab for high-risk localized rectal cancer

Abstract: XELOX plus bevacizumab followed by TME is feasible for high-risk localized rectal cancer, as it achieves good tumor regression and causes manageable toxicity.

Cited by 64 publications

References 29 publications

Pathological response of locally advanced rectal cancer to preoperative chemotherapy without pelvic irradiation

Pathological response of locally advanced rectal cancer to preoperative chemotherapy without pelvic irradiation

The efficacy of adding targeted agents to neoadjuvant therapy for locally advanced rectal cancer patients: a meta‐analysis

Neoadjuvant treatment for locally advanced rectal cancer: a systematic review

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