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Sequential Treatment with Bevacizumab and Aflibercept for Metastatic Colorectal Cancer in Real-World Clinical Practice

Publikace na Lékařská fakulta v Plzni, Fakulta tělesné výchovy a sportu, 1. lékařská fakulta |
2020

Tento text není v aktuálním jazyce dostupný. Zobrazuje se verze "en".Abstrakt

BACKGROUND: Bevacizumab and aflibercept are currently the mainstay of antiangiogenic therapy for metastatic colorectal carcinoma (mCRC). They are often used in sequence with first- and second-line chemotherapy, especially in patients with RAS-mutated tumours.

OBJECTIVE: The aim of the present study was to investigate the outcomes of patients with mCRC treated with the bevacizumab-aflibercept sequence in real-world clinical practice. PATIENTS AND METHODS: Data from a national clinical registry of targeted therapies for mCRC were analysed retrospectively.

Overall, there were 366 patients with valid data who received first-line treatment with bevacizumab and chemotherapy followed by aflibercept with chemotherapy. The majority of the patients (n = 296, 80.8%) had RAS mutated tumours.

RESULTS: Median cumulative progression-free survival (PFS) from the start of the bevacizumab-containing regimen to progression on aflibercept was 18.2 months (95% CI 16.8-19.5). Median PFS for bevacizumab and aflibercept was 10.6 months (95% CI 9.5-11.7) and 5.6 months (95% CI 5.1-6.1), respectively.

Longer PFS on aflibercept was associated with metachronous metastatic disease and longer PFS on bevacizumab. Median overall survival (OS) from the start of first-line bevacizumab was 32.0 months (95% CI 26.6-37.5).

The presence of metastatic disease at diagnosis was associated with worse OS. CONCLUSIONS: Patients treated with aflibercept in real-world clinical practice achieved similar survival outcomes as those treated within randomised trials.

Cumulative survival data provide a benchmark for future studies and enable indirect comparisons with other treatment sequences used in mCRC.