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Efficacy and Safety of Bevacizumab in Chinese Patients with Metastatic Colorectal Cancer

  • Zhu, Li-Ming (Department of Gastrointestinal Medical Oncology, Zhejiang Cancer Hospital) ;
  • Zhao, Ya-Zhen (Department of Gastrointestinal Medical Oncology, Zhejiang Cancer Hospital) ;
  • Ju, Hai-Xing (Department of Surgery, Zhejiang Cancer Hospital) ;
  • Liu, Lu-Ying (Department of Radiotherapy, Zhejiang Cancer Hospital) ;
  • Chen, Lei (Department of Gastrointestinal Medical Oncology, Zhejiang Cancer Hospital) ;
  • Liu, Bi-Xia (Department of Gastrointestinal Medical Oncology, Zhejiang Cancer Hospital) ;
  • Xu, Qi (Department of Gastrointestinal Medical Oncology, Zhejiang Cancer Hospital) ;
  • Luo, Cong (Department of Gastrointestinal Medical Oncology, Zhejiang Cancer Hospital) ;
  • Ying, Jie-Er (Department of Gastrointestinal Medical Oncology, Zhejiang Cancer Hospital) ;
  • Yang, Yun-Shan (Department of Gastrointestinal Medical Oncology, Zhejiang Cancer Hospital) ;
  • Zhong, Hai-Jun (Department of Gastrointestinal Medical Oncology, Zhejiang Cancer Hospital)
  • Published : 2014.08.30

Abstract

Objective: To evaluate the efficacy and safety of bevacizumab in the treatment of patients with metastatic colorectal cancer (mCRC). Methods: In a single-center, observational study of 91 Chinese patients with mCRC who received bevacizumab in combination with chemotherapy was conducted. Objective response rates (ORRs), progression-free survival (PFS), overall survival (OS) and adverse events were recorded, and the relationships between various clinical factors and PFS or OS were evaluated by Cox proportional hazards models. Results: Treatment with bevacizumab and chemotherapy was effective and tolerable. Univariate analysis showed that PFS and OS were significantly associated with the Eastern Cooperative Oncology Group performance status (ECOG-PS) score, duration of bevacizumab exposure, and whether chemotherapy was continued after discontinuation of bevacizumab treatment. A multivariate analysis showed that the duration of bevacizumab exposure and whether chemotherapy was continued after discontinuation of bevacizumab were independent prognostic factors for PFS and OS. Conclusion: In Chinese mCRC population, the shorter the duration of exposure to bevacizumab and chemotherapy, the worse the prognosis is.

Keywords

Metastatic colorectal cancer;chemotherapy;bevacizumab;efficacy;tolerability

References

  1. Park LC, Lee HS, Shin SH, et al (2012). Bevacizumab as a second- or later-line of treatment for metastatic colorectal cancer. World J Gastroenterol, 18, 1104-9. https://doi.org/10.3748/wjg.v18.i10.1104
  2. Saltz LB, Clarke S, Diaz-Rubio E, et al (2008). Bevacizumab in combination with oxaliplatin-based chemotherapy as firstline therapy in metastatic colorectal cancer: a randomized phase III study. J Clin Oncol, 26, 2013-9. https://doi.org/10.1200/JCO.2007.14.9930
  3. Stangl R, Altendorf-Hofmann A, Charnley RM, et al (1994). Factors influencing the natural history of colorectal liver metastases. Lancet, 343, 1405-10. https://doi.org/10.1016/S0140-6736(94)92529-1
  4. Van Cutsem E, Kohne CH, Hitre E, et al (2009). Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. N Engl J Med, 360, 1408-17. https://doi.org/10.1056/NEJMoa0805019
  5. Van Cutsem E, Rivera F, Berry S, et al (2009). Safety and efficacy of first-line bevacizumab with FOLFOX, XELOX, FOLFIRI and fluoropyrimidines in metastatic colorectal cancer: the BEAT study. Ann Oncol, 20, 1842-7. https://doi.org/10.1093/annonc/mdp233
  6. Wu Q, Shi Y, Chen L, et al (2013). Effect and safety of bevacizumab-containing chemotherapy treatment in Chinese patients with metastatic colorectal cancer. Onco Targets Ther, 6, 485-90.
  7. Adams RA, Meade AM, Seymour MT, et al (2011). Intermittent versus continuous oxaliplatin and fluoropyrimidine combination chemotherapy for first-line treatment of advanced colorectal cancer: results of the randomised phase 3 MRC COIN trial. Lancet Oncol, 12, 642-53. https://doi.org/10.1016/S1470-2045(11)70102-4
  8. Bendell JC, Bekaii-Saab TS, Cohn AL, et al (2012). Treatment patterns and clinical outcomes in patients with metastatic colorectal cancer initially treated with FOLFOXbevacizumab or FOLFIRI-bevacizumab: results from ARIES, a bevacizumab observational cohort study. Oncologist, 17, 1486-95. https://doi.org/10.1634/theoncologist.2012-0190
  9. Bennouna J, Sastre J, Arnold D, et al (2013). Continuation of bevacizumab after first progression in metastatic colorectal cancer (ML18147): a randomised phase 3 trial. Lancet Oncol, 14, 29-37. https://doi.org/10.1016/S1470-2045(12)70477-1
  10. Colucci G, Gebbia V, Paoletti G (2005). Phase III randomized trial of FOLFIRI versus FOLFOX4 in the treatment of advanced colorectal cancer: a multicenter study of the Gruppo Oncologico Dell'Italia Meridionale. J Clin Oncol, 23, 4866-75. https://doi.org/10.1200/JCO.2005.07.113
  11. Chen HX, Mooney M, Boron M, et al (2006). Phase II multicenter trial of bevacizumab plus fluorouracil and leucovorin in patients with advanced refractory colorectal cancer: an NCI Treatment Referral Center Trial TRC-0301. J Clin Oncol, 24, 3354-60. https://doi.org/10.1200/JCO.2005.05.1573
  12. Chibaudel B, Maindrault-Goebel F, Lledo G, et al (2009). Can chemotherapy be discontinued in unresectable metastatic colorectal cancer? The GERCOR OPTIMOX2 Study. J Clin Oncol, 27, 5727-33. https://doi.org/10.1200/JCO.2009.23.4344
  13. Cunningham D, Lang I, Marcuello E, et al (2013). Bevacizumab plus capecitabine versus capecitabine alone in elderly patients with previously untreated metastatic colorectal cancer (AVEX): an open-label, randomised phase 3 trial. Lancet Oncol, 14, 1077-85. https://doi.org/10.1016/S1470-2045(13)70154-2
  14. Dirican A, Varol U, Kucukzeybek Y, et al (2014). Treatment of metastatic colorectal cancer with or without bevacizumab: can the neutrophil/lymphocyte ratio predict the efficiency of bevacizumab? Asian Pac J Cancer Prev, 15, 4781-6. https://doi.org/10.7314/APJCP.2014.15.12.4781
  15. Douillard JY, Siena S, Cassidy J, et al (2010). Randomized, phase III trial of panitumumab with infusional fluorouracil, leucovorin, and oxaliplatin (FOLFOX4) versus FOLFOX4 alone as first-line treatment in patients with previously untreated metastatic colorectal cancer: the PRIME study. J Clin Oncol, 28, 4697-705. https://doi.org/10.1200/JCO.2009.27.4860
  16. Eisenhauer EA, Therasse P, Bogaerts J, et al (2009). New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer, 45, 228-47. https://doi.org/10.1016/j.ejca.2008.10.026
  17. Giantonio BJ, Catalano PJ, Meropol NJ, et al (2007). Bevacizumab in combination with oxaliplatin, fluorouracil, and leucovorin (FOLFOX4) for previously treated metastatic colorectal cancer: results from the Eastern Cooperative Oncology Group Study E3200. J Clin Oncol, 25, 1539-44. https://doi.org/10.1200/JCO.2006.09.6305
  18. Guan ZZ, Xu JM, Luo RC, et al (2011). Efficacy and safety of bevacizumab plus chemotherapy in Chinese patients with metastatic colorectal cancer: a randomized phase III ARTIST trial. Chin J Cancer, 30, 682-9. https://doi.org/10.5732/cjc.011.10188
  19. Hurwitz H, Fehrenbacher L, Novotny W, et al (2004). Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med, 350, 2335-42. https://doi.org/10.1056/NEJMoa032691
  20. Kopetz S, Chang GJ, Overman MJ, et al (2009). Improved survival in metastatic colorectal cancer is associated with adoption of hepatic resection and improved chemotherapy. J Clin Oncol, 27, 3677-83. https://doi.org/10.1200/JCO.2008.20.5278
  21. Kozloff M, Yood MU, Berlin J, et al (2009). Clinical outcomes associated with bevacizumab-containing treatment of metastatic colorectal cancer: the BRiTE observational cohort study. Oncologist, 14, 862-70. https://doi.org/10.1634/theoncologist.2009-0071
  22. Kang BW, Kim TW, Lee JL, et al (2009). Bevacizumab plus FOLFIRI or FOLFOX as third-line or later treatment in patients with metastatic colorectal cancer after failure of 5-fluorouracil, irinotecan, and oxaliplatin: a retrospective analysis. Med Onvcol, 26, 32-7.
  23. Koopman M, Simkens LH, Ten Tije AJ, et al (2013). Maintenance treatment with capecitabine and bevacizumab versus observation after induction treatment with chemotherapy and bevacizumab in metastatic colorectal cancer (mCRC): the phase III CAIRO3 study of the Dutch Colorectal Cancer Group (DCCG). J Clin Oncol, 31, Abstract 3502.
  24. Koeberle D, Betticher DC, Von Moos R, et al (2013). Bevacizumab continuation versus no continuation after firstline chemo-bevacizumab therapy in patients with metastatic colorectal cancer: a randomized phase III noninferiority trial (SAKK 41/06). J Clin Oncol, 31, Abstract 3503.

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