A Potential Administration-time Dependent Effect of Bevacizumab in Improving Overall Survival and Increasing Metastasis in Metastatic Colorectal Cancer

Zhang, Bei; He, Weiling; Zhou, Feifei; Guo, Guifang; Jiang, Chang; Yin, Chenxi; Chen, Xuxian; Qiu, Huijuan; Rong, Yuming; Xia, Liangping

doi:10.4172/2167-7700.1000108

Cited by 4 publications

(10 citation statements)

References 49 publications

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“…There have been few studies focused on the effect of bevacizumab in Chinese mCRC patients 5,31,32. The ARTIST study was the only randomized Phase III clinical trial, and it found that both OS and PFS were improved with the addition of bevacizumab 5.…”

Section: Discussionmentioning

confidence: 99%

“…The ARTIST study was the only randomized Phase III clinical trial, and it found that both OS and PFS were improved with the addition of bevacizumab 5. Then, our previous case-control study, which analyzed data from patients before 2010, found that when bevacizumab was used for at least four cycles, there was an improvement of OS, although the PFS was not investigated 31. Recently, a retrospective study with a small patient number showed the efficacy and safety profiles of bevacizumab in first-line, second-line, and even the third-line treatment in Chinese patients 32.…”

Section: Discussionmentioning

confidence: 99%

“…More than four cycles of bevacizumab were required, since four cycles of bevacizumab was the minimum requirement to benefit patients found in our previous study;26 5) serum LDH was tested before the initiation of the first-line chemotherapy. The consecutive mCRC patients in the control group met the same criteria as the study group except for bevacizumab administration.…”

Section: Methodsmentioning

confidence: 99%

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Initial LDH level can predict the survival benefit from bevacizumab in the first-line setting in Chinese patients with metastatic colorectal cancer

Yin

Jiang

Liao³

et al. 2014

OTT

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BackgroundMarkers to predict the efficacy of bevacizumab treatment have been not fully validated in most cancers, including metastatic colorectal cancer (mCRC). The aim of this study was to investigate the potential role of lactate dehydrogenase (LDH) in predicting the survival benefit from first-line bevacizumab treatment, in Chinese patients with mCRC.MethodsAll the patients were diagnosed with mCRC at the Sun Yat-sen University Cancer Center from 2003 to 2013. The study group and the control group were classified by receiving bevacizumab or not. The serum LDH value of all the patients had been detected before the first-line treatment. The primary end point was progression-free survival (PFS).ResultsThe median PFS of the study and the control group (patients who received bevacizumab or not) was 11.3 and 9.1 months, respectively (P=0.004). In the control group, the median PFS of the high LDH level and the low LDH level groups was 6.9 and 10.2 months, respectively (P<0.001). However, in the study group, the corresponding median PFS was 9.9 and 11.9 months, respectively (P=0.145). In addition, for the low LDH level group, the median PFS was 11.9 and 10.2 months for patients who received bevacizumab or not, respectively (P=0.066); however, the median PFS of patients receiving bevacizumab or not was significantly different in the high LDH level group (9.9 and 6.9 months, respectively) (P=0.012).ConclusionThe addition of bevacizumab in the first-line treatment setting could improve the PFS of mCRC patients notably. However, the benefit could only be potentially reflected on patients with high serum LDH level.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Initial LDH level can predict the survival benefit from bevacizumab in the first-line setting in Chinese patients with metastatic colorectal cancer

Yin

Jiang

Liao³

et al. 2014

OTT

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“…Patients in chemotherapy plus bevacizumab group received more than 4 cycles bevacizumab (at a dose of 5 mg/kg on day 1) 17 was administered as a combination with the standard oxaliplatin-based or irinotecan-based first-line chemotherapy. None of the patients had previously or subsequently received other target therapies.…”

Section: Methodsmentioning

confidence: 99%

The Prognostic and Predictive Value of Carbohydrate Antigen 19-9 in Metastatic Colorectal Cancer Patients with First Line Bevacizumab Containing Chemotherapy

Jiang

Liu

et al. 2017

J. Cancer

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Objective: We had previously demonstrated that the carbohydrate antigen 19-9 (CA19-9), lactate dehydrogenase (LDH), neutrophil lymphocyte ratio (NLR) are prognostic factors for patients with metastatic colorectal cancer (mCRC). In this study, we try to analysis the association of these blood-based biomarkers with bevacizumab efficacy in the first line setting.Methods: A total of 284 eligible consecutive mCRC patients who received first-line chemotherapy with or without bevacizumab were studied from 2007 to 2014 at Sun Yat-Sen University Cancer Center. The endpoints were overall survival (OS), progression free survival (PFS).Results: Among all the patients, the initial elevated CA19-9, high LDH, and NLR > 2.47 were confirmed as independent unfavorable prognostic factors. The CA19-9 and LDH levels were significantly associated with PFS. In the high CA19-9 subgroup, patients had favorable OS from bevacizumab administration in the first line therapy (32.1 vs. 20.1 months, P = 0.03), but without PFS benefit. In terms of different levels of LDH, and NLR, there were no survival benefit from bevacizumab treatment.Conclusions: Our results suggest that the initial CA19-9, LDH, and NLR levels could be independent prognostic biomarkers in mCRC patients. And among all these factors, the initial high CA19-9 level could be a predictor for bevacizumab effect.

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“…Patients who met the following criterions were selected as study group: 1) Diagnosed as mCRC based on pathological specimens of the primary tumor, at the same time with clinical and/or pathological evidences of distant metastasis lesion, at the Sun Yat-sen University Cancer Center from 2007 to 2013 and finished the entire course of first- and second-line chemotherapy in this center 2) Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2; 3) Bevacizumab was added to the palliative regimens including oxaliplatin-based, irinotecan-based regimens and so on; 4) More than 4 cycles of bevacizumab was required, since 4 cycles was considered the minimum course for the patients got benefit from bevacizummab in our previous study 22 . Meanwhile, the consecutive mCRC patients in the control group met the same criterions with the study group except for bevacizumab administration.…”

Section: Methodsmentioning

confidence: 99%

The Efficacy of Bevacizumab in Different Line Chemotherapy for Chinese Patients with Metastatic Colorectal Cancer

Yin¹,

Ma²,

Rong³

et al. 2016

J. Cancer

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Objective: To evaluate the effect of bevacizumab in different lines for Chinese patients with metastatic colorectal cancer (mCRC).Methods: Patients of mCRC treated with bevacizumab or not at Sun Yat-sen University Cancer Center from 2007 to 2013 were recruited as study and control group. Endpoints were overall survival (OS), progression free survival (PFS), objective response rate (ORR) and disease control rate (DCR). Corresponding survival rates of first- and second-line in study and control group were compared.Results: 1. Median OS of study and control group were 44.8 (95% CI: 37.1~52.4) months, 36.1 (95% CI: 32.8~39.5) months respectively, which were significantly different (P=0.004). 2. In the first line treatment, median OS of study and control group were 49.9(95% CI: 40.1~59.8) months and 36.1 (95% CI: 32.7~39.4) months (P=0.002), respectively. And median PFS were 10.1(95% CI: 8.7~11.5) months and 6.2 (95% CI: 5.5~6.8) months (P<0.001), respectively. 3. In the second line treatment, median OS of study and control group were 34.8 (95% CI: 26.3~43.3) months and 24.6 (95% CI: 22.2~27.0) months (P=0.022), respectively. And the mPFS were 6.3 (95% CI: 4.7~7.8) months and 3.1 (95% CI: 2.5~3.6) months (P<0.001), respectively. 4. Median OS of first- and second-line treatment of the study groups were 49.9(95% CI: 40.1~59.8) months and 34.8 (95% CI: 26.3~43.3) months (P=0.189), respectively.Conclusion: The combination of bevacizumab and chemotherapy had a promising efficacy in Chinese mCRC patients. However, their OS were statistically insignificant between first- and second-line of bevacizumab groups.

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A Potential Administration-time Dependent Effect of Bevacizumab in Improving Overall Survival and Increasing Metastasis in Metastatic Colorectal Cancer

Cited by 4 publications

References 49 publications

Initial LDH level can predict the survival benefit from bevacizumab in the first-line setting in Chinese patients with metastatic colorectal cancer

Initial LDH level can predict the survival benefit from bevacizumab in the first-line setting in Chinese patients with metastatic colorectal cancer

The Prognostic and Predictive Value of Carbohydrate Antigen 19-9 in Metastatic Colorectal Cancer Patients with First Line Bevacizumab Containing Chemotherapy

The Efficacy of Bevacizumab in Different Line Chemotherapy for Chinese Patients with Metastatic Colorectal Cancer

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