Key clinical point: The risk for grade 3-4 (G3-4) neutropenia and febrile neutropenia (FN) is higher with FOLFOXIRI/bevacizumab vs doublets/bevacizumab as first-line treatment of metastatic colorectal cancer (mCRC), with the risk being higher in older females, who may benefit with prophylactic use of granulocyte colony-stimulating factor.
Major finding: The incidence of G3-4 neutropenia (51% vs 21%; P < .001), FN (8% vs 4%; P = .02), and high-risk FN (3% vs 1%; P = .015) was significantly higher with FOLFOXIRI/bevacizumab vs doublet/bevacizumab, mostly during the first cycles. The risk for G3-4 neutropenia was significantly higher among older patients ( P = .01) and females ( P < .001).
Study details: This pooled analysis included 1,155 patients with untreated mCRC from TRIBE1 and TRIBE 2 phase 3 trials, of which 568 patients received FOLFOXIRI/bevacizumab and 587 received doublet/bevacizumab (FOLFIRI/bevacizumab; n=254 or FOLFOX/bevacizumab; n=335).
Disclosures: This study was supported by GONO and ARCO Foundations. Some of the authors declared receiving honoraria, travel grant, research funding, speakers’ bureau, and/or consulting or advisory role for various sources.
Source: Rossini D et al. ESMO Open. 2021 Oct 21. doi: 10.1016/j.esmoop.2021.100293 .