Phase II Trial of Neoadjuvant Bevacizumab with Modified FOLFOX7 in Patients with Stage II and III Rectal Cancer

Abstract

• Neoadjuvant bevacizumab with modified FOLFOX7 without radiation failed to meet the goal of pathological complete response rate; however, the low number of recurrence and disease-free survival in this population, with predominantly stage III, is encouraging and worth further exploration. • The racial distribution of the patient population, as well as a wait time of more than 4 weeks after last chemotherapy, may have contributed to the findings.

Neoadjuvant Bevacizumab Plus Docetaxel/Cisplatin/Capecitabine Chemotherapy in Locally Advanced Gastric Cancer Patients: A Pilot Study

“…In all gastric cancer, locally advanced gastric cancer (LAGC) is a special type since the prognosis of patients with LAGC is dramatically different between resectable and unresectable ones ( 5 – 7 ); therefore, creating surgery opportunities for the patients with unresectable LAGC by neoadjuvant chemotherapy is necessary ( 8 – 11 ). Meanwhile, it is also critical to optimize surgical conditions for the patients with resectable LAGC by neoadjuvant chemotherapy, which reduces postoperative recurrence, thus further improving survival in these patients ( 12 – 14 ). Among the regimens of neoadjuvant chemotherapy, docetaxel, cisplatin, and capecitabine (DCC), chemotherapy is tolerable and brings promising efficacy with a 5-year survival rate of 54% in R0 patients with resected LAGC ( 15 ).…”

“…Bevacizumab (BEV), an angiogenesis inhibitor, binds to vascular endothelial growth factor (VEGF)-A to prevent the interaction of VEGF-A with the VEGF receptor, then suppresses the VEGF signaling pathway, thereby inhibiting neovascularization ( 16 , 17 ). Nowadays, BEV plus chemotherapy as a neoadjuvant regimen is used in patients with locally advanced cancers ( 14 , 18 , 19 ). For instance, neoadjuvant BEV plus oxaliplatin, leucovorin, and 5-fluorouracil realize a pathological downstaging rate of 65% in locally advanced rectal cancer patients ( 14 ); moreover, another research illustrates that BEV plus paclitaxel and carboplatin as a neoadjuvant regimen achieves 100% objective response rate (ORR) and an optimal pathological response of 38% in patients with locally advanced cervical cancer ( 18 ); besides, as for unresectable stage III lung adenocarcinoma patients, neoadjuvant BEV plus pemetrexed and carboplatin induces pathologic downstaging rate of 73.8% and 1-year event-free survival rate of 56.1% ( 19 ).…”

“…Nowadays, BEV plus chemotherapy as a neoadjuvant regimen is used in patients with locally advanced cancers ( 14 , 18 , 19 ). For instance, neoadjuvant BEV plus oxaliplatin, leucovorin, and 5-fluorouracil realize a pathological downstaging rate of 65% in locally advanced rectal cancer patients ( 14 ); moreover, another research illustrates that BEV plus paclitaxel and carboplatin as a neoadjuvant regimen achieves 100% objective response rate (ORR) and an optimal pathological response of 38% in patients with locally advanced cervical cancer ( 18 ); besides, as for unresectable stage III lung adenocarcinoma patients, neoadjuvant BEV plus pemetrexed and carboplatin induces pathologic downstaging rate of 73.8% and 1-year event-free survival rate of 56.1% ( 19 ). Based on the above-mentioned information, we hypothesized that BEV plus chemotherapy as neoadjuvant therapy might be a promising regimen in LAGC, while it is rarely applied in LAGC.…”