Clinical outcomes of Chinese patients with metastatic colorectal cancer receiving first-line bevacizumab-containing treatment

Abstract

After the approval of bevacizumab for the first-line treatment of metastatic colorectal cancer (mCRC) in China, published information was still limited. This observational cohort study enrolled 175 mCRC patients who initiated bevacizumab-containing first-line chemotherapies at Sun Yet-sen University Cancer Center. Backbone chemotherapies included FOLFIRI (45.6 %), FOLFOX (34.9 %), and XELOX (19.5 %). Effectiveness data, safety profiles, and treatment patterns were collected and compared between oxaliplatin- and irinotecan-based groups. The median treatment durations of bevacizumab in first-line and total were equivalent between oxaliplatin- and irinotecan-based group (5.0 vs. 4.8 and 6.0 vs. 5.9 months, respectively). Median progression-free survival (PFS) was 10.6 months, and median overall survival (OS) was 24.2 months in entire population. No significant difference was found between irinotecan- and oxaliplatin-based groups in PFS (10.8 vs. 10.1 months, p = 0.21) or in OS (27.5 vs. 23.7 months, p = 0.68). Overall response rate in entire population was 38.3 %, and the disease control rate was 86.3 %. Bevacizumab-associated serious adverse events included hypertension (4.2 %), bleeding (3.6 %), proteinuria (3.0 %), venous thromboembolism (0.6 %), and wound-healing complications (0.6 %). Curative-intent surgery after conversion chemotherapy was carried out in 23 patients (13.7 %). Multivariate analyses showed that maintenance therapy (p = 0.001), resection of metastatic sites (p = 0.002), and disease-free interval (p = 0.003) were independent prognostic factors for OS survival. In spite of small discrepancies in treatment patterns, irinotecan- and oxaliplatin-based chemotherapeutic regimens are equally compatible partners for bevacizumab in first-line Chinese mCRC treatment.

Safety and Management of Toxicity Related to Aflibercept in Combination with Fluorouracil, Leucovorin and Irinotecan in Malaysian Patients with Metastatic Colorectal Cancer

“…Grade 3-4 neutropenia (16%) and infections (12%) were seen in fewer patients. The risk of developing proteinuria was also observed with bevacizumab-related therapies in other studies (Bai et al, 2015;Passardi et al, 2015;Yoshida et al, 2015;Majid et al, 2015). The control of BP is complicated and may be related to the factors affecting cardiac output or total peripheral vascular resistance (Syed and McKeage., 2015).…”

Chemotherapy plus bevacizumab versus chemotherapy plus cetuximab as first-line treatment for patients with metastatic colorectal cancer

“…[15–17] Their optimal use in terms of patient selection, drug combinations, and regimen sequences remains inconclusive. [18–21] …”

A plasma cytokine and angiogenic factor (CAF) analysis for selection of bevacizumab therapy in patients with metastatic colorectal cancer

“…Angiogenesis was a critical component in carcinogenesis and tumor growth, and therapies targeting tumor angiogenesis were major steps in the treatment of metastatic colorectal cancer (mCRC) 1 . Bevacizumab, the vascular endothelial growth factor-A (VEGF-A) monoclonal antibody, was the first proven target agent in the treatment of metastatic colorectal cancer (mCRC) and currently was a standard of care for mCRC patients in combination with first-line chemotherapy 2 3 4 . Despite the overall success of bevacizumab, clinical efficacy was variable and some individuals seemed to be resistant against it, resulting in rather modest gains in overall survival (OS) under bevacizumab-containing therapies 5 6 7 .…”