A trial looking at bevacizumab (Avastin) and chemotherapy for bowel cancer that has only spread to the liver (BOXER)

This trial looked at bevacizumab (Avastin) and chemotherapy for people with bowel cancer that had spread to their liver, but to nowhere else.

People with bowel cancer that has spread to the liver (liver secondaries) usually have chemotherapy. Capecitabine and oxaliplatin are two of the common chemotherapy drugs used. These drugs may help to relieve symptoms and to control the growth of cancer.

It is not usually possible to remove liver secondaries with surgery when they are first diagnosed. But in a small number of people, chemotherapy shrinks the cancer enough to make surgery possible. Having surgery to remove the liver secondaries may offer a better chance to control the cancer and for some people may be a cure.

Bevacizumab is a type of biological therapy called a monoclonal antibody.

The aim of this trial was to find out how well adding bevacizumab to chemotherapy would work for people with secondary cancer in the liver.

Recruitment

Start 01/06/2005

End 15/01/2009

Phase

Phase 2

Summary of results

The trial team found that bevacizumab added to chemotherapy works well for people with bowel cancer that has spread to the liver only.

Of the 46 people recruited to this trial, 45 had bevacizumab with their chemotherapy.

After 12 weeks treatment everyone had a scan to measure their liver secondaries. When the researchers looked at the scans they found the cancer in the liver

Could not be seen in 4 people
Had shrunk in 31 people
Had stayed the same in 7 people
Had continued to grow in 3 people

Of the 45 people, 18 had surgery to remove their liver secondaries.

The most common side effects reported were

A drop in blood cells
Tiredness
Diarrhoea
Tingling, numbness or pain in the hands and feet – peripheral neuropathy

The trial team concluded that adding bevacizumab to chemotherapy was a safe treatment that worked well. In addition it could allow more people to have surgery to remove the secondary cancer in the liver.

We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (peer reviewed) and published in a medical journal. The figures we quote above were provided by the trial team. We have not analysed the data ourselves.