# TRIBE

Source: https://onco.cc/trials/tribe/  
OnCo record `tribe` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Giving all three chemotherapy drugs at once instead of two shrank more tumours and delayed progression, at the cost of more side effects.

## Summary

TRIBE randomised 508 patients with untreated metastatic colorectal cancer to FOLFIRI plus bevacizumab or FOLFOXIRI plus bevacizumab, up to twelve cycles followed by fluorouracil and bevacizumab maintenance. Median progression-free survival was 12.1 against 9.7 months (hazard ratio 0.75, 95% CI 0.62 to 0.90, p=0.003) and the objective response rate 65 against 53 percent (p=0.006). Overall survival was longer but not significantly so in the primary report (31.0 against 25.8 months, hazard ratio 0.79, p=0.054). Grade 3 or 4 neurotoxicity, stomatitis, diarrhoea and neutropenia were all more common with the triplet. TRIBE is why FOLFOXIRI plus bevacizumab is chosen when tumour shrinkage matters most: in BRAF-mutant disease, in young fit patients and when liver metastases might be made resectable.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-24
- Registry id: NCT00719797
- Phase: 3
- Setting: Untreated metastatic colorectal cancer: FOLFOXIRI plus bevacizumab against FOLFIRI plus bevacizumab
- Sponsor: Gruppo Oncologico del Nord-Ovest
- Enrolled: 508
- Result: Progression-free survival 12.1 against 9.7 months (hazard ratio 0.75); response rate 65 against 53 percent.
- Outcomes: Progression-free survival: FOLFOXIRI plus bevacizumab 12.1 months vs FOLFIRI plus bevacizumab 9.7 months, HR 0.75; Overall survival: FOLFOXIRI plus bevacizumab 31 months vs FOLFIRI plus bevacizumab 25.8 months, HR 0.79
- Replication: TRIBE2 confirmed the strategy against a planned sequence of doublets; CAIRO5 found FOLFOXIRI plus bevacizumab best for right-sided or RAS/BRAF-mutant liver-only disease.

## Sources

- ClinicalTrials.gov NCT00719797: https://clinicaltrials.gov/study/NCT00719797
- TRIBE: initial therapy with FOLFOXIRI and bevacizumab for metastatic colorectal cancer (New England Journal of Medicine 2014): https://doi.org/10.1056/NEJMoa1403108

## Connected records

- cancers: [Colorectal cancer](https://onco.cc/cancers/colorectal/)
- technologies: [Anti-angiogenic therapy](https://onco.cc/technologies/antiangiogenic/), [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/), [Platinum agents](https://onco.cc/technologies/platinum/), [Topoisomerase-I inhibitors (and ADC payloads)](https://onco.cc/technologies/topoisomerase-inhibitors/)
- targets: [VEGF / VEGFR](https://onco.cc/targets/vegf/)
- drugs: [Bevacizumab](https://onco.cc/drugs/bevacizumab/), [Fluorouracil (5-FU)](https://onco.cc/drugs/fluorouracil/), [FOLFIRI (5-FU, leucovorin, irinotecan)](https://onco.cc/drugs/folfiri/), [FOLFOXIRI (5-FU, leucovorin, oxaliplatin, irinotecan)](https://onco.cc/drugs/folfoxiri/), [Irinotecan (and liposomal irinotecan)](https://onco.cc/drugs/irinotecan/), [Oxaliplatin](https://onco.cc/drugs/oxaliplatin/)
- trials: [CAIRO5](https://onco.cc/trials/cairo5/), [TRIBE2](https://onco.cc/trials/tribe2/)

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