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Benefit of Bevacizumab-Based Frontline Therapy in Patients with Metastatic Colorectal Cancer (mCRC): a Turkish Oncology Group Study

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Abstract

Background

Several chemotherapy regimens using bevacizumab have been developed. Our goal was to investigate regimens that have demonstrated significant clinical activity in patients with metastatic colorectal cancer (mCRC).

Materials and Methods

Six hundred and sixty six patients with mCRC who received first-line chemotherapy combination with bevacizumab were studied. Fluoropyrimidine (F) plus irinotecan (I)-based (FI-bev), F plus oxaliplatin (O)-based (FO-bev), and F-based (F-bev) treatment regimens were compared with respect to progression-free survival (PFS) and overall survival (OS).

Results

The median PFS of FI-bev (n = 414) was 10.9 months (95 % CI 10–11.8), of FO-bev (n = 211) was 9.4 months (95 % CI 8.3–10.4), and of F-bev (n = 41) was 9.5 months (95 % CI 5.9–13.1) (p = 0.089). The median OS of FI-bev was 26.3 months (95 % CI 21.7–30.9), of FO-bev was 27 months (95 % CI 24.3–29.7), and of F-bev was 23.3 months (95 % CI 12.7–33.9) (p = 0.102). In KRAS wild-type patients, the median PFS of FI-bev group was significantly longer than FO-bev group (10.5 vs. 9.1 months, p = 0.006). The FI-bev group had better OS than FO-bev group with borderline significance (p = 0.058). The FI-bev group had significantly longer OS than F-bev group. Patients who underwent metastasectomy or those with Eastern Cooperative Oncology Group performance status (ECOG-PS) ≤1 had longer PFS and OS independent of the type of chemotherapy regimen.

Conclusion

FI-bev may be the preferred frontline regimen for patients with KRAS wild-type mCRC. Metastasectomy and performance score were the strongest positive predictors of OS and PFS regardless of backbone chemotherapy regimen.

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Acknowledgments

The authors thank Philip A. Philip, MD, of Karmanos Cancer Center, for the helpful discussion during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Medical Oncology, Necmettin Erbakan University, Meram Medical Faculty, 42080, Konya, Turkey

    Mehmet Artaç, Levent Korkmaz & Mustafa Karaağaç

  2. Department of Medical Oncology, Akdeniz University Faculty of Medicine, Antalya, Turkey

    Hasan Şenol Coşkun

  3. Department of Medical Oncology, Marmara University Faculty of Medicine, Istanbul, Turkey

    Faysal Dane

  4. Department of Medical Oncology, Ege University Faculty of Medicine, Izmir, Turkey

    Bülent Karabulut

  5. Department of Medical Oncology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey

    Devrim Çabuk

  6. Department of Medical Oncology, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey

    Senem Karabulut & Nuri Faruk Aykan

  7. Department of Medical Oncology, Acıbadem Bursa Hospital, Bursa, Turkey

    Hatice Doruk

  8. Department of Medical Oncology, Ali Osman Sönmez Oncology Hospital, Bursa, Turkey

    Nilüfer Avcı

  9. Department of Medical Oncology, Anadolu Medical Center, Istanbul, Turkey

    Nazım Serdar Turhal

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  1. Mehmet Artaç
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  12. Nazım Serdar Turhal
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Correspondence to Mehmet Artaç.

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The study was approved by the ethics committee at Necmettin Erbakan University, Meram Faculty of Medicine and carried out in accordance with the Declaration of Helsinki and all applicable regulations.

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None of the authors has any potential financial conflict of interest related to this manuscript.

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Artaç, M., Coşkun, H.Ş., Dane, F. et al. Benefit of Bevacizumab-Based Frontline Therapy in Patients with Metastatic Colorectal Cancer (mCRC): a Turkish Oncology Group Study. J Gastrointest Canc 47, 264–272 (2016). https://doi.org/10.1007/s12029-016-9823-7

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