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|Title:||Previous bevacizumab and efficacy of later anti-epidermal growth factor receptor antibodies in metastatic colorectal cancer: results from a large international registry.|
|Other Authors:||Burge, Matthew|
Dean, Andrew P.
Steel, Simone A.
Lok, Sheau Wen
Metastatic Colorectal Cancer
Treatment of Recurrent and Advanced Colorectal Cancer
Department of Medical Oncology, Epworth Hospital, Richmond, Victoria, Australia
General Surgery and Gastroenterology Clinical Institute, Epworth HealthCare, Victoria, Australia
|Citation:||Clin Colorectal Cancer. 2018 Sep;17(3):e593-e599.|
|Abstract:||BACKGROUND: The FIRE-3 [5-fluorouracil, folinic acid, and irinotecan (FOLFIRI) plus cetuximab versus FOLFIRI plus bevacizumab in first line treatment colorectal cancer (CRC)] study reported that first-line FOLFIRI plus cetuximab versus FOLFIRI plus bevacizumab resulted in similar progression-free survival (PFS) but improved overall survival (OS). A potential explanation is that the initial biologic agent administered in metastatic CRC (mCRC) affects later line efficacy of the other treatments. We sought to test this hypothesis. MATERIALS AND METHODS: We interrogated our mCRC registry (Treatment of Recurrent and Advanced Colorectal Cancer) regarding treatment and outcome data for RAS wild-type patients receiving epidermal growth factor receptor inhibitors (EGFRIs) in second and subsequent lines. Survival outcomes from the beginning of EGFRI use were determined as a function of previous bevacizumab use and the interval between ceasing bevacizumab and beginning EGFRI use. RESULTS: Of 2061 patients, 222 eligible patients were identified, of whom 170 (77%) had received previous bevacizumab and 52 (23%) had not. PFS and OS from the start of EGFRIs did not differ by previous bevacizumab use (3.8 vs. 4.2 months; hazard ratio [HR], 1.12; P = .81; 9.0 vs. 9.2 months; HR, 1.19; P = .48, respectively) for the whole cohort or when analyzed by the primary tumor side (HR for left side, 1.07; P = .57; HR for right side, 1.2; P = .52). PFS was significantly shorter with right-sided primary tumors when the interval between bevacizumab and EGFRI use was < 6 versus > 6 months (median, 2.2 vs. 6 months; HR, 2.23; P = .01) but not with left-sided tumors (median, 4.2 vs. 5.5 months; HR, 1.12; P = .26). CONCLUSION: Previous bevacizumab use had no effect on the activity of subsequent EGFRIs. The apparent effect of time between biologic agents in right-sided tumors might reflect patient selection.|
|Journal Title:||Clinical Colorectal Cancer|
|Affiliated Organisations:||Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia; University of Queensland, St Lucia, Brisbane, Queensland, Australia|
Systems Biology and Personalised Medicine Division, Walter and Eliza Hall Institute for Medical Research, Parkville, Victoria, Australia
Department of Medical Biology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
Department of Surgery, Royal Melbourne Hospital, Parkville, Victoria, Australia
Department of Medical Oncology, Western Health, St Albans, Victoria, Australia
Department of Medical Oncology, Eastern Health, Box Hill, Victoria, Australia
Department of Medical Oncology, Cabrini Health, Malvern, Victoria, Australia
Department of Medicine, Monash University, Clayton, Victoria, Australia
Department of Clinical Oncology, Chinese University of Hong Kong, New Territories, Hong Kong
Department of Medical Oncology, St John of God Subiaco Hospital, Subiaco, Western Australia, Australia
Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia.
Department of Medical Oncology, Goulburn Valley Health, Shepparton, Victoria, Australia
Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia; University of Queensland, St Lucia, Brisbane, Queensland, Australia
|Appears in Collections:||General Surgery and Gastroenterology|
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