Aurora Kinase Inhibitors  conditions that would impair the ability of the patient to receive protocol treatment. In addition, patients were excluded if they had metastasis of the central nervous system or a history of uncontrolled gastrointestinal bleeding, thromboembolism,hypertension, or proteinuria. The study was approved by the institutional ethics review board, and all patients provided written informed consent.For grade 3 hematologic and non-hematologic toxicities, the capecitabine dose was decreased by 25% from baseline on the Wrst occurrence, 50% from baseline on the 2nd occurrence, and capecitabine was permanently discontinued if it occurred a third time.

For grade 4 hematologic and non-hematologic toxicities, the dose was decreased by 50% from baseline on the Wrst occurrence and permanently stopped on the second occurrence.For grade 3 hematologic and non-hematologic toxicities, the irinotecan dose was decreased by 25 mg/m2 from baseline on the Wrst occurrence, 50 mg/m2 from baseline on the 2nd occurrence, and irinotecan was permanently discontinued if it occurred a third time. For grade 4 hematologic and non-hematologic toxicities, the dose was decreased by 50 mg/m2 from baseline on the Wrst occurrence and permanently  Semagacestat stopped on the second occurrence.For the following events, bevacizumab was to be discontinued permanently: gastrointestinal perforation, arterial thromboembolic events, grade 3 or 4 hemorrhagic events, symptomatic grade 4 venous thromboembolic events, grade 4 hypertension, and grade 4 proteinuria.

For grade 2 or 3 hypertension, bevacizumab was held until it improved to grade 1. For grade 3 and asymptomatic grade 4 venous thrombosis, bevacizumab was held for 2 weeks.The protocol recommended that patients with severe diarrhea be closely monitored and given electrolyte and Xuid replacement as medically indicated. Anti-diarrheal treatments were recommended to be promptly initiated as medically indicated. The use of subcutaneous octreotide was recommended for refractory chemotherapy-induced diarrhea when hospitalization was required.There have been signiWcant improvements in outcomes for mCRC with the incorporation of multiple new active agents. Several studies have demonstrated the beneWt of adding bevacizumab to 5-FU-based chemotherapy, but there are limited data on the use of bevacizumab in combination with capecitabine and irinotecan (XELIRI).

In our trial, a regimen consisting of dose-modiWed capecitabine and irinotecan with authority bevacizumab showed promising activity and was well tolerated. In summary, with modest dose reduction, the combination of bevacizumab, irinotecan, and capecitabine was well tolerated. Furthermore, treatment eYcacy was not compromised since outcomes in the current study compared favorably with those from other Wrst-line trials. This combination may be considered another option for Wrst-line therapy in patients with mCRC. Despite a remarkable decline in its incidence during the second half of the 20th century, gastric cancer remains the fourth most common cancer worldwide and the second most common cause of death from cancer. Almost two thirds of the cases occur in developing countries and 42% in China alone.