Retrospective study of low- versus high-dose 5-FU in triplet chemotherapy plus bevacizumab for metastatic colorectal cancer

Recent randomized clinical trials found that among patients with metastatic colorectal cancer (mCRC) and good performance status, first-line triplet chemotherapy plus bevacizumab (TripletBev) resulted in improved overall survival when compared to doublet chemotherapy plus bevacizumab, albeit with increased rates of neutropenia and diarrhea. These trials used high-dose continuous-infusion 5-fluorouracil (3200 mg/m² per 48 hours). A retrospective cohort study using data of a US patient database compared overall survival of mCRC patients receiving TripletBev with high-dose 5-FU with OS of patients receiving TripletBev with low-dose 5-FU (2400 mg/m² ± 10%). There was no significant difference in overall survival between the groups. The median overall survival was 34.2 months for low-dose 5-FU versus 34.0 months for high-dose 5-FU. The authors conclude that high-dose 5-FU in first-line TripletBev for mCRC did not confer OS-benefit versus low-dose 5-FU.