Phase II Study of Gemcitabine and Oxaliplatin in Combination With Bevacizumab in Patients With Advanced Hepatocellular Carcinoma

作者：Andrew X. Zhu, Lawrence S. Blaszkowsky, David P. Ryan, Jeffrey W. Clark, Alona Muzikansky, Kerry Horgan, Susan Sheehan, K Hale, Peter C. Enzinger, Pankaj Bhargava, Keith Stuart · 发表于：Journal of Clinical Oncology · 年份：2006 · DOI：10.1200/jco.2005.04.9130 · 被引用次数：387 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Colorectal Cancer Treatments and Studies、Cholangiocarcinoma and Gallbladder Cancer Studies

PURPOSE: Hepatocellular carcinoma (HCC) is a vascular tumor with poor prognosis. Given the reported activity of gemcitabine and oxaliplatin (GEMOX) in HCC and the potential benefits of targeting the vascular endothelial growth factor pathway with bevacizumab (B), a phase II study of GEMOX-B was undertaken to define efficacy and toxicity profiles in HCC patients. PATIENTS AND METHODS: Eligible patients had pathologically proven measurable unresectable or metastatic HCC. For cycle 1 (14 days), bevacizumab 10 mg/kg was administered alone intravenously on day 1. For cycle 2 and beyond (28 days/cycle), bevacizumab 10 mg/kg was administered on days 1 and 15, gemcitabine 1,000 mg/m2 was administered as a dose rate infusion at 10 mg/m2/min followed by oxaliplatin at 85 mg/m2 on days 2 and 16. RESULTS: Thirty-three patients were enrolled and 30 patients were assessable for efficacy. The objective response rate was 20%, and 27% of patients had stable disease. Median overall survival was 9.6 months (95% CI, 8.0 months to not available) and median progression-free survival (PFS) was 5.3 months (95% CI, 3.7 to 8.7 months); the PFS rate at 3 and 6 months was 70% (95% CI, 54% to 85%) and 48% (95% CI, 31% to 65%), respectively. The most common treatment-related grade 3 to 4 toxicities included leukopenia/neutropenia, transient elevation of aminotransferases, hypertension, and fatigue. CONCLUSION: GEMOX-B could be safely administered with close monitoring and had moderate antitumor activity f...