The median duration of the overall survival (OS) and progression-free survival (PFS) was 14

The median duration of the overall survival (OS) and progression-free survival (PFS) was 14.0 mo and 6.13 mo, respectively. was an active and safe treatment option for patients failing oxaliplatin-based therapy[20]. The role of bevacizumab in combination with FL as a third-line treatment was studied in a phase II trial of patients who failed irinotecan- and oxlaiplain-based chemotherapy regimens. Based on previous study, the use of third-line FL plus bevacizumab in chemoresistant patients is considered an ineffective treatment[14]. However, additional reports presented different results than this previous report after bevacizumab combined chemotherapy as a third-lime treatment. Bevacizumab with FOLFIRI was reported to be well tolerated and to be a feasible treatment in patients with heavily treated advanced MCRC[21]. Two studies evaluated the efficacy and safety of bevacizumab plus FOLFIRI or FOLFOX in MCRC after failure with FOLFIRI and FOLFOX using a retrospective analysis. These studies concluded that bevacizumab plus FOLFIRI or FOLFOX as third-line or PD-1-IN-22 later treatment in patients with MCRC resulted in a modest activity and was relatively tolerable[16,22]. A summary of the data during bevacizumab-combined chemotherapy as a second- or later-line treatment in patients with MCRC is shown in Table ?Table44. Table 4 Summary of the data after bevacizumab-combined chemotherapy as second- and later-line treatment in patients with metastatic colorectal cancer after failure of irinotecan, oxaliplatin and 5-fluorouracil thead align=”center” Ref.Treatment lineTreatment regimen em n /em ORR (%)Median PFS (mo)Median OS (mo) /thead Giantonio et al[12]SecondBV + FOLFOX428722.77.312.9FOLFOX42858.64.710.8BV2343.32.710.2Yildiz et al[20]SecondBV + Irinotecan-based therapy4020.06.014.0Chen et al[14]ThirdBV + FU/LV1004.03.79.1Kwon et al[21]ThirdBV + FOLFIRI1428.53.910.9Livre et al[22]Second or later-lineBV + FOLFIRI or FOLFOX3132.29.718.4Kang et al[16]Third or later-lineBV + FOLFIRI or FOLFOX429.55.39.5Park et alSecond or later-lineBV + FOLFIRI or FOLFOX407.56.1314.0 Open in a separate window BV: Bevacizumab; FOLFOX4: Fluoropyrimidine + oxaliplatin; FOLFIRI: Fluoropyrimidine + irinotecan; FU/LV: Fluoropyrimidine + leucovorin; OS: Overall survival; PFS: Progression-free survival; ORR: Overall response rate. In the present study, the ORR was 7.5% for all of the patients, and the median duration of the OS and PFS was 14.0 mo and 6.13 mo, respectively. We suggest that bevacizumab combined chemotherapy as a second- or later-line treatment is an active and tolerable treatment in patients with MCRC after failure to response to previous chemotherapy. COMMENTS Background The addition of bevacizumab to NFKBIA 5-fluorouracil (5-FU)-based combination chemotherapy as the first-line treatment results in a clinically meaningful improvement in the survival of patients with metastatic colorectal cancer (MCRC). Research frontiers Based on the inconclusive results from multicenter studies, the role of bevacizumab in the treatment of patients with disease that is refractory to 5-FU, irinotecan, and oxaliplatin is unclear. Innovations and breakthroughs In previous studies, bevacizumab combined chemotherapy as a second- or later-line treatment was shown to have controversial results. In the present study, three patients exhibited partial responses, resulting in an overall response rate of 7.5%. The median duration of the overall survival (OS) and progression-free survival (PFS) was 14.0 mo and 6.13 mo, respectively. The median OSs were 16.60, 14.07 and 13.00 mo for the second-line, third-line and fourth- or later-line treatments, respectively. The median PFSs were 7.23 mo, 7.30 mo, and 3.87 mo the second-line, third-line and fourth- or later-line treatments, respectively. Applications The results of the present study suggest that bevacizumab combined chemotherapy as a second- or later-line treatment is an active and tolerable treatment option for PD-1-IN-22 patients with MCRC after failure to previous chemotherapy. Peer review The present study is a good descriptive retrospective study that evaluated the efficacy of bevacizumab plus chemotherapy in patients with MCRC who have failed prior chemotherapy without bevacizumab. Footnotes Peer reviewer: Benjamin Perakath, Colorectal Surgery, Christian Medical College, Vellore, Department of Surgery Unit 2, Vellore 632004, India S- Editor Gou PD-1-IN-22 SX L- Editor A E- Editor Zheng XM.