Efficacy and tolerability of Avastin plus Xeloda as first-line therapy in patients with advanced Liver Cancer

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Liver cancer is the fifth most common cancer worldwide and the third most common cause of cancer mortality.  More than 80% of cases occur in East Asia and sub-Sharan Africa, and the incidence is increasing in Europe and the US.

Patients with locally advanced or metastatic HCC have dismal outcome.  Typically, the median survival for these patients diagnosed in Asia was typically 2-4 months with best supportive care.

Currently, Nexavar (sorafenib) is the only targeted agent indicated for advanced HCC.  A new study published indicated that Avastin (bevacizumab) plus Xeloda (capecitabine) might be another option for patients with advanced liver cancer.

In the study, a total of 45 patients with extrahepatic metastasis were enrolled to receive bevacizumab and capecitabine.  Overall, the median progression-free survival (PFS) and overall survival (OS) were 2.7 and 5.9 months, respectively.  The overall response rate (RECIST) was 9% and the disease control rate was 52%.

Treatment-related grade 3 or 4 non-hematological toxicities included diarrhea (4%) nausea/vomiting (2%), gastrointestinal bleeding (9%) and hand-foot syndrome (9%).

Even though the anti-tumor activity of this combination was modest when compared with sorafenib (overall survival rate 7-11 months),  its good tolerability profile might be an option for people who can not tolerate sorafenib.

Source: British Journal of Cancer (2010) 102, 981-986

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