Acta clinica Croatica, Vol. 65. No. 1, 2026.
Izvorni znanstveni članak
https://doi.org/10.20471/acc.2026.65.01.11
The Impact of Maintenance Therapy with Fluoropyrimidines and Bevacizumab on Progression-Free and Overall Survival in First-Line Treatment Protocols Including Irinotecan Among Patients with Metastatic Colorectal Cancer: A Retrospective Real-World Study
Ilijan Tomaš
; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Oncology, University Hospital Centre Osijek, Osijek, Croatia
Dora Muršić
; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Oncology, University Hospital Centre Osijek, Osijek, Croatia
*
Vedrana Pavlović
; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Oncology, University Hospital Centre Osijek, Osijek, Croatia
Sebastijan Spajić
; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Oncology, University Hospital Centre Osijek, Osijek, Croatia
Dominik Seletković
; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Oncology, University Hospital Centre Osijek, Osijek, Croatia
Laura Zahirović
; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Oncology, University Hospital Centre Osijek, Osijek, Croatia
Kristina Kralik
; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Josipa Flam
; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Oncology, University Hospital Centre Osijek, Osijek, Croatia
* Dopisni autor.
Sažetak
Background: While maintenance therapy is established in metastatic colorectal
cancer (mCRC), data following irinotecan-based protocols remain limited de-
spite widespread use in Europe.
Methods: This retrospective study included 136 mCRC patients treated at Uni-
versity Hospital Centre Osijek (2017–2021) receiving first-line irinotecan-based
chemotherapy (CAPIRI/FOLFIRI) with bevacizumab. Patients received either con-
tinuous therapy until progression, or maintenance with fluoropyrimidines and
bevacizumab after first-line irinotecan-based chemotherapy until progression
(PFS1), and then reinduction of first-line therapy until disease progression (PFS2).
Primary endpoints were progression-free survival (PFS) and overall survival (OS).
Results: Maintenance therapy showed significantly superior outcomes versus
continuous therapy. PFS1 was 21 months (95% CI, 10–66) versus 12 months
(95% CI, 10–17; P < 0.001); PFS2 was not reached at the time of data cut-off ver-
sus 12 months (95% CI, 10–17; P < 0.001). Overall survival favored maintenance
therapy numerically (77 months vs not reached) without statistical significance
(P = 0.13). The median duration of induction chemotherapy was 11 months and
of maintenance therapy 9 months.
Conclusion: Maintenance therapy with fluoropyrimidines and bevacizumab fol-
lowing irinotecan-based induction chemotherapy demonstrates significant PFS
benefits in real-world practice, supporting its use to balance disease control
with reduced toxicity in mCRC patients.
Ključne riječi
Maintenance therapy; Metastatic colorectal cancer; Bevacizumab; FOLFIRI; CAPIRI
Hrčak ID:
345838
URI
Datum izdavanja:
27.3.2026.
Posjeta: 337 *