{"entity":{"id":"tribe","kind":"trial","name":"TRIBE","aka":[],"tldr":"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.","status":"positive","asOf":"2026-09-24","links":[{"label":"ClinicalTrials.gov NCT00719797","url":"https://clinicaltrials.gov/study/NCT00719797"},{"label":"TRIBE: initial therapy with FOLFOXIRI and bevacizumab for metastatic colorectal cancer (New England Journal of Medicine 2014)","url":"https://doi.org/10.1056/NEJMoa1403108"}],"tags":[],"related":[],"cancers":["colorectal"],"sections":[],"technologies":["cytotoxic-chemotherapy","antiangiogenic","platinum","topoisomerase-inhibitors"],"targets":["vegf"],"drugs":["folfoxiri","folfiri","bevacizumab","irinotecan","oxaliplatin","fluorouracil"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["tribe2","cairo5"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT00719797","phase":"3","setting":"Untreated metastatic colorectal cancer: FOLFOXIRI plus bevacizumab against FOLFIRI plus bevacizumab","sponsor":"Gruppo Oncologico del Nord-Ovest","result":"Progression-free survival 12.1 against 9.7 months (hazard ratio 0.75); response rate 65 against 53 percent.","yearReported":2014,"enrolled":508,"enrolledBasis":"randomised","enrolledNote":"The registry lists 509 participants; 508 were randomised in the New England Journal of Medicine report.","outcomes":[{"endpoint":"Progression-free survival","primary":true,"unit":"months","arms":[{"name":"FOLFOXIRI plus bevacizumab","value":12.1},{"name":"FOLFIRI plus bevacizumab","value":9.7}],"hr":0.75,"ci":[0.62,0.9],"p":"0.003","source":"https://doi.org/10.1056/NEJMoa1403108"},{"endpoint":"Overall survival","unit":"months","arms":[{"name":"FOLFOXIRI plus bevacizumab","value":31},{"name":"FOLFIRI plus bevacizumab","value":25.8}],"hr":0.79,"p":"0.054","source":"https://doi.org/10.1056/NEJMoa1403108"}],"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."},"route":"/trials/tribe/","neighbours":{"cancer":[{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"}],"technology":[{"id":"antiangiogenic","kind":"technology","name":"Anti-angiogenic therapy","route":"/technologies/antiangiogenic/"},{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"},{"id":"platinum","kind":"technology","name":"Platinum agents","route":"/technologies/platinum/"},{"id":"topoisomerase-inhibitors","kind":"technology","name":"Topoisomerase-I inhibitors (and ADC payloads)","route":"/technologies/topoisomerase-inhibitors/"}],"target":[{"id":"vegf","kind":"target","name":"VEGF / VEGFR","route":"/targets/vegf/"}],"drug":[{"id":"bevacizumab","kind":"drug","name":"Bevacizumab","route":"/drugs/bevacizumab/"},{"id":"fluorouracil","kind":"drug","name":"Fluorouracil (5-FU)","route":"/drugs/fluorouracil/"},{"id":"folfiri","kind":"drug","name":"FOLFIRI (5-FU, leucovorin, irinotecan)","route":"/drugs/folfiri/"},{"id":"folfoxiri","kind":"drug","name":"FOLFOXIRI (5-FU, leucovorin, oxaliplatin, irinotecan)","route":"/drugs/folfoxiri/"},{"id":"irinotecan","kind":"drug","name":"Irinotecan (and liposomal irinotecan)","route":"/drugs/irinotecan/"},{"id":"oxaliplatin","kind":"drug","name":"Oxaliplatin","route":"/drugs/oxaliplatin/"}],"trial":[{"id":"cairo5","kind":"trial","name":"CAIRO5","route":"/trials/cairo5/"},{"id":"tribe2","kind":"trial","name":"TRIBE2","route":"/trials/tribe2/"}]}}