The impact of bevacizumab in metastatic colorectal cancer with an intact primary tumor: Results from a large prospective cohort study

Abstract

Of 1204 mCRC patients, 826 (69%) were eligible for inclusion. Bevacizumab use was similar in both arms (IPT (64%) versus RPT (70%)); compared with chemotherapy alone, bevacizumab use was associated with significantly longer PFS (IPT: 8.5 months vs 4.7 months, P = 0.017; RPT: 10.8 months vs 5.8 months, P < 0.001) and OS (IPT: 20 months vs 14.8 months, P = 0.005; RPT: 24.4 months vs 17.3 months, P = 0.004)). Bevacizumab use in an IPT was associated with more GI perforations (4.5% vs 1.8%, P = 0.210) but less frequent bleeding (1.5% vs 5.3%, P = 0.050) and thrombosis (1.5% vs 2.7%, P = 0.470), versus chemotherapy alone. Median survival was equivalent between patients that did or did not experience bevacizumab-related adverse events - 20.0 months versus 19.9 months, hazard ratio = 0.98, P = 0.623. CONCLUSIONS: The addition of bevacizumab significantly improved survival outcomes in mCRC with an IPT. The occurrence of bevacizumab-related adverse events did not significantly impact survival outcomes.

Bevacizumab improves survival in metastatic colorectal cancer patients with primary tumor resection: A meta-analysis

“…The left 14 studies were further reviewed by full-text, and half of them were excluded as they were lack of sufficient data and reviews. Finally, seven clinical studies 2,3,11,14,16,17,24 were regarded as eligible and included for the final quantitative synthesis. The detailed study selection process is presented in Fig.…”

“…Among seven included studies, five 3,11,14,16,24 of them were retrospective trials and two 2,17 were prospective studies published from 2011 to 2016. The median age ranged from 52 to 66.…”

“…The PFS was between 9 and 10.8 months in the resection group, while they were between 7 and 9 months in no resection group. Few of the included trials reported HR directly, while HRs were calculated from survival curves from other studies 2,3,11,14,16,17 , indirectly. The method was mentioned in the statistical analysis section.…”

“…These studies suggested that surgery of primary tumor was associated with better survival when managed with bevacizumab. Although positive results emerged, an agreement about the impact of primary tumor resection on bevacizumab has not yet been reached 3,16,17 . These studies are not capable of providing encouraging evidence for guiding use of bevacizumab or predicting efficacy of bevacizumab based on primary tumor resection in mCRC.…”

Simulating Progression-Free and Overall Survival for First-Line Doublet Chemotherapy With or Without Bevacizumab in Metastatic Colorectal Cancer Patients Based on Real-World Registry Data

“…To date, almost 3000 patients have been enrolled in TRACC, and detailed patient and disease characteristics, treatment history of primary disease, and metastatic treatment motivation and outcomes across multiple treatment lines were all collected prospectively. TRACC data have been used previously to assess, for example, trends in biological agent use [32], primary tumor site impact on PFS and OS [33], and PFS, OS, and several safety endpoints for patients with an intact compared with a resected primary tumor [34].…”