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Randomized Phase III Study of Capecitabine, Oxaliplatin, and Bevacizumab with or without Cetuximab in Advanced Colorectal Cancer (ACC), the CAIRO2 Study of the Dutch Colorectal Cancer Group (DCCG)

Carolyn Vachani, RN, MSN, AOCN
The Abramson Cancer Center of the University of Pennsylvania
Last Modified: June 4, 2008

Randomized Phase III Study of Capecitabine, Oxaliplatin, and Bevacizumab with or without Cetuximab in Advanced Colorectal Cancer (ACC), the CAIRO2 Study of the Dutch Colorectal Cancer Group (DCCG)

This study compared patients with advanced colorectal cancers treated with capcitabine, oxaliplatin and bevacizumab (COB) versus COB + cetuximab. Bevacizumab inhibits the vascular endothelial growth factor (VEGF) receptor, and cetuximab inhibits EGFR. Researchers theorized that combining the two targeted therapies might result in better outcomes.

This unfortunately did not prove to be true. The addition of cetuximab had no effect on overall survival, and actually resulted in worse progression-free survival. The rates of toxicities were higher with the addition of cetuximab. There is some suggestion that there could be a benefit for carefully selected patients. This study highlights the fact that newer targeted therapies are not without toxicities, and combining them may not always be possible.