What are the results of adjuvant chemotherapy combined with targeted therapy for colorectal cancer?

  The aim was to explore the value of capecitabine ± bevacizumab for adjuvant chemotherapy in stage II/III colorectal cancer. 1941 patients with high-risk stage II/III colorectal cancer (11.6% rectal) were randomized to receive adjuvant chemotherapy with capecitabine (Cape) alone for 6 months or capecitabine for 6 months + bevacizumab (Bev) for 1 year after radical surgery, in a superiority design trial with a primary endpoint was DFS (disease-free survival), assuming a 3-year DFS improvement from 66% to 72%.  The safety profile was similar to other trials of bevacizumab, with increased hypertension, proteinuria, and impaired wound healing. Final results 3-year DFS trial group (Cape/Bev) 75.4%, control group (Cape) 78.4%, HR=1.06, p=0.5. 3-year OS, 87.5% vs. 89.4%, HR=1.11, p=0.3. Finally, the QUASAR-2 trial, selected by the Congress as LBA, still did not surprise us, as expected;  These results are consistent with the previously published results of AVANT, NSABP C-08 with bevacizumab combined with XELOX/FOLFOX adjuvant chemotherapy, where bevacizumab not only failed to increase the efficacy of capecitabine adjuvant chemotherapy, but likewise brought about impaired survival. Therefore, as Professor Grothey commented, the door is closed for targeted therapy in adjuvant chemotherapy for colorectal cancer.