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

Cancer type:

Bowel (colorectal) cancer
Cancer spread to the liver
Secondary cancers




Phase 2

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

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.

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

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 Open a glossary item) and published in a medical journal. The figures we quote above were provided by the trial team. We have not analysed the data ourselves.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Professor David Cunningham

Supported by

Cancer Research UK
Experimental Cancer Medicine Centre (ECMC)
National Institute for Health Research Cancer Research Network (NCRN)
The Royal Marsden NHS Foundation Trust

Other information

This is Cancer Research UK trial number CRUKE/06/043.

Questions about cancer? Contact our information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:

Oracle 867

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Wendy took part in a new trial studying the possible side effect of hearing loss

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"I was delighted to take part in a clinical trial as it has the potential to really help others in the future.”

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