Neoadjuvant oxaliplatin and capecitabine and bevacizumab without radiotherapy for poor-risk rectal cancer: N-SOG 03 phase II trial

Keisuke Uehara, Kazuhiro Hiramatsu, Atsuyuki Maeda, Eiji Sakamoto, Masaya Inoue, Satoshi Kobayashi, Yuichiro Tojima, Yuichiro Yoshioka, Goro Nakayama, Hiroshi Yatsuya, Naoki Ohmiya, Hidemi Goto, Masato Nagino

研究成果: Article

58 引用 (Scopus)

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Objective: This Phase II trial was designed to evaluate the safety and efficacy of neoadjuvant oxaliplatin and capecitabine and bevacizumab without radiotherapy in patients with poor-risk rectal cancer. Methods: Patients with magnetic resonance imaging-defined poor-risk rectal cancer received neoadjuvant oxaliplatin and capecitabine and bevacizumab followed by total mesorectal excision or more extensive surgery. Results: Between February 2010 and December 2011, 32 patients were enrolled in this study. The completion rate of the scheduled chemotherapy was 91%. Reasons for withdrawal were refusal to continue therapy in two patients and disease progression in one, with two of these three patients not undergoing surgery. Among the 29 patients who completed the scheduled chemotherapy, one refused surgery within 8 weeks after the completion of chemotherapy, which was the period stipulated by the protocol, and another had rectal perforation, requiring urgent laparotomy. As a result, the completion rate of this experimental treatment was 84%. Of the 30 patients who underwent surgery, the R0 resection rate was 90% and a postoperative complication occurred in 43%. A pathological complete response was observed in 13% and good tumor regression was exhibited in 37%. Conclusions: Neoadjuvant oxaliplatin and capecitabine plus bevacizumab for poor-risk rectal cancer caused a high rate of anastomotic leakage and experienced a case with perforation during chemotherapy, both of which were bevacizumab-related toxicity. Although the shortterm results with the completion rate of 84.4% and the pathological complete response rate of 13.3% were satisfactory, we have to reconsider the necessity of bevacizumab in neoadjuvant chemotherapy (UMIN number, 000003507).

元の言語English
記事番号hyt115
ページ(範囲)964-971
ページ数8
ジャーナルJapanese journal of clinical oncology
43
発行部数10
DOI
出版物ステータスPublished - 01-10-2013

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oxaliplatin
Rectal Neoplasms
Radiotherapy
Drug Therapy
Anastomotic Leak
Bevacizumab
Capecitabine
Laparotomy
Disease Progression

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

これを引用

Uehara, Keisuke ; Hiramatsu, Kazuhiro ; Maeda, Atsuyuki ; Sakamoto, Eiji ; Inoue, Masaya ; Kobayashi, Satoshi ; Tojima, Yuichiro ; Yoshioka, Yuichiro ; Nakayama, Goro ; Yatsuya, Hiroshi ; Ohmiya, Naoki ; Goto, Hidemi ; Nagino, Masato. / Neoadjuvant oxaliplatin and capecitabine and bevacizumab without radiotherapy for poor-risk rectal cancer : N-SOG 03 phase II trial. :: Japanese journal of clinical oncology. 2013 ; 巻 43, 番号 10. pp. 964-971.
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title = "Neoadjuvant oxaliplatin and capecitabine and bevacizumab without radiotherapy for poor-risk rectal cancer: N-SOG 03 phase II trial",
abstract = "Objective: This Phase II trial was designed to evaluate the safety and efficacy of neoadjuvant oxaliplatin and capecitabine and bevacizumab without radiotherapy in patients with poor-risk rectal cancer. Methods: Patients with magnetic resonance imaging-defined poor-risk rectal cancer received neoadjuvant oxaliplatin and capecitabine and bevacizumab followed by total mesorectal excision or more extensive surgery. Results: Between February 2010 and December 2011, 32 patients were enrolled in this study. The completion rate of the scheduled chemotherapy was 91{\%}. Reasons for withdrawal were refusal to continue therapy in two patients and disease progression in one, with two of these three patients not undergoing surgery. Among the 29 patients who completed the scheduled chemotherapy, one refused surgery within 8 weeks after the completion of chemotherapy, which was the period stipulated by the protocol, and another had rectal perforation, requiring urgent laparotomy. As a result, the completion rate of this experimental treatment was 84{\%}. Of the 30 patients who underwent surgery, the R0 resection rate was 90{\%} and a postoperative complication occurred in 43{\%}. A pathological complete response was observed in 13{\%} and good tumor regression was exhibited in 37{\%}. Conclusions: Neoadjuvant oxaliplatin and capecitabine plus bevacizumab for poor-risk rectal cancer caused a high rate of anastomotic leakage and experienced a case with perforation during chemotherapy, both of which were bevacizumab-related toxicity. Although the shortterm results with the completion rate of 84.4{\%} and the pathological complete response rate of 13.3{\%} were satisfactory, we have to reconsider the necessity of bevacizumab in neoadjuvant chemotherapy (UMIN number, 000003507).",
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Uehara, K, Hiramatsu, K, Maeda, A, Sakamoto, E, Inoue, M, Kobayashi, S, Tojima, Y, Yoshioka, Y, Nakayama, G, Yatsuya, H, Ohmiya, N, Goto, H & Nagino, M 2013, 'Neoadjuvant oxaliplatin and capecitabine and bevacizumab without radiotherapy for poor-risk rectal cancer: N-SOG 03 phase II trial', Japanese journal of clinical oncology, 巻. 43, 番号 10, hyt115, pp. 964-971. https://doi.org/10.1093/jjco/hyt115

Neoadjuvant oxaliplatin and capecitabine and bevacizumab without radiotherapy for poor-risk rectal cancer : N-SOG 03 phase II trial. / Uehara, Keisuke; Hiramatsu, Kazuhiro; Maeda, Atsuyuki; Sakamoto, Eiji; Inoue, Masaya; Kobayashi, Satoshi; Tojima, Yuichiro; Yoshioka, Yuichiro; Nakayama, Goro; Yatsuya, Hiroshi; Ohmiya, Naoki; Goto, Hidemi; Nagino, Masato.

:: Japanese journal of clinical oncology, 巻 43, 番号 10, hyt115, 01.10.2013, p. 964-971.

研究成果: Article

TY - JOUR

T1 - Neoadjuvant oxaliplatin and capecitabine and bevacizumab without radiotherapy for poor-risk rectal cancer

T2 - N-SOG 03 phase II trial

AU - Uehara, Keisuke

AU - Hiramatsu, Kazuhiro

AU - Maeda, Atsuyuki

AU - Sakamoto, Eiji

AU - Inoue, Masaya

AU - Kobayashi, Satoshi

AU - Tojima, Yuichiro

AU - Yoshioka, Yuichiro

AU - Nakayama, Goro

AU - Yatsuya, Hiroshi

AU - Ohmiya, Naoki

AU - Goto, Hidemi

AU - Nagino, Masato

PY - 2013/10/1

Y1 - 2013/10/1

N2 - Objective: This Phase II trial was designed to evaluate the safety and efficacy of neoadjuvant oxaliplatin and capecitabine and bevacizumab without radiotherapy in patients with poor-risk rectal cancer. Methods: Patients with magnetic resonance imaging-defined poor-risk rectal cancer received neoadjuvant oxaliplatin and capecitabine and bevacizumab followed by total mesorectal excision or more extensive surgery. Results: Between February 2010 and December 2011, 32 patients were enrolled in this study. The completion rate of the scheduled chemotherapy was 91%. Reasons for withdrawal were refusal to continue therapy in two patients and disease progression in one, with two of these three patients not undergoing surgery. Among the 29 patients who completed the scheduled chemotherapy, one refused surgery within 8 weeks after the completion of chemotherapy, which was the period stipulated by the protocol, and another had rectal perforation, requiring urgent laparotomy. As a result, the completion rate of this experimental treatment was 84%. Of the 30 patients who underwent surgery, the R0 resection rate was 90% and a postoperative complication occurred in 43%. A pathological complete response was observed in 13% and good tumor regression was exhibited in 37%. Conclusions: Neoadjuvant oxaliplatin and capecitabine plus bevacizumab for poor-risk rectal cancer caused a high rate of anastomotic leakage and experienced a case with perforation during chemotherapy, both of which were bevacizumab-related toxicity. Although the shortterm results with the completion rate of 84.4% and the pathological complete response rate of 13.3% were satisfactory, we have to reconsider the necessity of bevacizumab in neoadjuvant chemotherapy (UMIN number, 000003507).

AB - Objective: This Phase II trial was designed to evaluate the safety and efficacy of neoadjuvant oxaliplatin and capecitabine and bevacizumab without radiotherapy in patients with poor-risk rectal cancer. Methods: Patients with magnetic resonance imaging-defined poor-risk rectal cancer received neoadjuvant oxaliplatin and capecitabine and bevacizumab followed by total mesorectal excision or more extensive surgery. Results: Between February 2010 and December 2011, 32 patients were enrolled in this study. The completion rate of the scheduled chemotherapy was 91%. Reasons for withdrawal were refusal to continue therapy in two patients and disease progression in one, with two of these three patients not undergoing surgery. Among the 29 patients who completed the scheduled chemotherapy, one refused surgery within 8 weeks after the completion of chemotherapy, which was the period stipulated by the protocol, and another had rectal perforation, requiring urgent laparotomy. As a result, the completion rate of this experimental treatment was 84%. Of the 30 patients who underwent surgery, the R0 resection rate was 90% and a postoperative complication occurred in 43%. A pathological complete response was observed in 13% and good tumor regression was exhibited in 37%. Conclusions: Neoadjuvant oxaliplatin and capecitabine plus bevacizumab for poor-risk rectal cancer caused a high rate of anastomotic leakage and experienced a case with perforation during chemotherapy, both of which were bevacizumab-related toxicity. Although the shortterm results with the completion rate of 84.4% and the pathological complete response rate of 13.3% were satisfactory, we have to reconsider the necessity of bevacizumab in neoadjuvant chemotherapy (UMIN number, 000003507).

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