Retrospective analysis of pathological response in colorectal cancer liver metastases following treatment with bevacizumab

Vera, Ruth; Dorronsoro, Marisa Gómez; López‐Ben, Santiago; Viúdez, A.; Queralt, Bernardo; Hernandez, Irene; Ortiz, Rosa; Zazpe, C.; Soriano, Jordi; Amat, Irene; Cabezón, Javier Herrera; Díaz, Esther; Codina-Barreras, Antoni; Hernández-Yagüe, X.; Quera, Antonio Rigo; Figueras, Joan

doi:10.1007/s12094-013-1142-x

Cited by 19 publications

(14 citation statements)

References 33 publications

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“…[12] Compared to chemotherapy alone, the addition of bevacizumab improved liver metastases response rate. [3,13,14] In the present study, we evaluated the response of colorectal metastases by using imaging technology and confirmed that the addition of bevacizumab can lead to higher response rate compared with preoperative chemotherapy alone (59.4% vs 38.6%). For patients with initially unresectable liver metastases, a strong correlation between response rate and resection rate in neoadjuvant treatment of mCRC was demonstrated.…”

Section: Discussionsupporting

confidence: 60%

Bevacizumab with preoperative chemotherapy versus preoperative chemotherapy alone for colorectal cancer liver metastases

Lü¹,

Peng²,

Wang³

et al. 2016

Medicine

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This study aimed to assess the efficacy and safety of bevacizumab plus preoperative chemotherapy as first-line treatment for liver-only metastatic colorectal cancer in Chinese patients compared with those of preoperative chemotherapy alone.Patients with histologically confirmed liver-only metastatic colorectal cancer were sequentially reviewed, and received either preoperative chemotherapy plus bevacizumab (bevacizumab group, n = 32) or preoperative chemotherapy alone (chemotherapy group, n = 57). Progression-free survival, response rate, liver resection rate, conversion rate, and safety were analyzed.With median follow-up of 28.7 months, progression-free survival was 10.9 months (95% confidence interval: 8.7–13.1 months) in bevacizumab group and 9.9 months (95% confidence interval: 6.8–13.1 months) in chemotherapy group (P = 0.472). Response rates were 59.4% in bevacizumab group and 38.6% in chemotherapy group (P = 0.059). Overall liver resection (R0, R1, and R2) rate was 68.8% in bevacizumab group and 54.4% in chemotherapy group (P = 0.185). Conversion rate was 51.9% in bevacizumab group and 40.4% in chemotherapy group (P = 0.341). No postoperative complication was observed in all patients.Bevacizumab plus preoperative chemotherapy as first-line treatment for liver-only metastatic colorectal cancer tends to achieve better clinical benefit with controllable safety in Chinese patients.

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Section: Discussionsupporting

confidence: 60%

Bevacizumab with preoperative chemotherapy versus preoperative chemotherapy alone for colorectal cancer liver metastases

Lü¹,

Peng²,

Wang³

et al. 2016

Medicine

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“…Based on our pooled results, we find that NCT plus bevacizumab could employ a role in the neoadjuvant setting for CRLM patients in particular in terms of ORR and R0 hepatic resection rate, while comparable efficacy is found between NCT plus EGFR-MoAbs and NCT alone in terms of hepatic resection rate and R0 hepatic resection rate. Additionally, several retrospective studies have demonstrated that the addition of bevacizumab to chemotherapy in the neoadjuvant and conversion setting significantly improve pathological response in CRLM patients, and patients with a good pathological response to neoadjuvant chemotherapy are associated with a better outcome [ 41 , 55 , 56 ]. Based on these encouraging data, the combination of NCT plus bevacizumab as neoadjuvant and conversion therapy could be recommended for initially unresectable or resectable CRLM patients due to its higher ORR and R0 hepatic resection rate.…”

Section: Discussionmentioning

confidence: 99%

Neoadjuvant chemotherapy (NCT) plus targeted agents versus NCT alone in colorectal liver metastases patients: A systematic review and meta-analysis

et al. 2015

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PurposeTo assess the efficacy of neoadjuvant chemotherapy (NCT) plus targeted agents versus NCT alone for the treatment of colorectal liver metastases (CRLM) patients.MethodsTrials published between 1994 and 2015 were identified by an electronic search of public databases (MEDLINE, EMBASE, Cochrane library). All clinical studies were independently identified by two authors for inclusion. Demographic data, treatment regimens, objective response rate (ORR), hepatic resection and R0 hepatic resection rate were extracted and analyzed using Comprehensive MetaAnalysis software (Version 2.0).ResultsA total of 40 cohorts with 2099 CRLM patients were included: 962 patients were treated with NCT alone, 602 with NCT plus anti-epidermal growth-factor receptor (EGFR)-monoclonal antibodies (MoAbs) and 535 with NCT plus bevacizumab. Pooled ORR was significantly higher for NCT plus bevacizumab or anti-EGFR-MoAbs than NCT alone [relative risk (RR) 1.53, 95% CI 1.30–1.80; p < 0.001; RR 1.53, 95% CI: 1.27–1.83, p < 0.001; respectively]. NCT plus bevacizumab significantly improved R0 hepatic resection rate (RR 1.61, 95% CI: 1.27–2.04, p < 0.001), but not for overall hepatic resection rate (RR 1.26, 95% CI: 0.81–1.94, p = 0.30). While hepatic resection and R0 hepatic resection rate was comparable between NCT plus anti-EGFR-MoAbs and NCT alone (p = 0.42 and p = 0.37, respectively).ConclusionsIn comparison with NCT alone, NCT plus bevacizumab significantly improve ORR and R0 hepatic resection rate but not for hepatic resection rate. Our findings support the need to compare NCT plus bevacizumab with NCT alone in the neoadjuvant setting in large prospective trials due to its higher hepatic resection rate and R0 hepatic resection rate in CRLM patients.

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“…Although the relevance of the cytotoxic backbone added to preoperative bevacizumab is yet unclear, recent data seem to indicate that the optimization of the associated regimen could impact bevacizumab-induced increase in pathologic response rate [47]. Moreover, bevacizumab had been shown to improve the degree of pathological response [48], and to induce an unusual, infarct-like necrosis [49]; both conditions have been reported to be associated with better prognosis [18]. In practice, however, no imaging technique is able to predict preoperatively the achievement of complete pathological response, despite the complete radiologic response on diagnostic imaging [23,50,51].…”

Section: Which Is the Effect Of Bevacizumab On The Pathology Of Livermentioning

confidence: 99%

Use of Bevacizumab in the Management of Potentially Resectable Colorectal Liver Metastases: Safety, Pathologic Assessment and Benefit

Innominato

Adam

2016

Curr Colorectal Cancer Rep

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Liver metastases are a frequent and commonly lethal complication of colorectal cancer. Surgical resection of limited liver disease offers currently the best chance of longterm survival, but surgery is not feasible for a rather significant proportion of patients with hepatic metastases. Despite the overall improvement in the medical management of patients with metastatic colorectal cancer, whose median survival has been substantially prolonged with the availability of novel drugs, long-term outcomes remain rather poor if a combined onco-surgical strategy cannot be implemented. Nonetheless, newer chemotherapy schedules have become more frequently, rapidly and deeply active, improving hepatic lesions' downsizing, hence extending the pool of patients amenable to secondary liver surgery. Here, we summarize available data on the efficacy and safety of bevacizumab, an anti-VEGF monoclonal antibody indicated for the treatment of metastatic colorectal cancer, as a conversion chemotherapeutic option in the management of patients with liver metastases.

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Retrospective analysis of pathological response in colorectal cancer liver metastases following treatment with bevacizumab

Cited by 19 publications

References 33 publications

Bevacizumab with preoperative chemotherapy versus preoperative chemotherapy alone for colorectal cancer liver metastases

Bevacizumab with preoperative chemotherapy versus preoperative chemotherapy alone for colorectal cancer liver metastases

Neoadjuvant chemotherapy (NCT) plus targeted agents versus NCT alone in colorectal liver metastases patients: A systematic review and meta-analysis

Use of Bevacizumab in the Management of Potentially Resectable Colorectal Liver Metastases: Safety, Pathologic Assessment and Benefit

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