Progression-Free Survival in Patients Receiving Chemotherapy Alone (C) or Chemotherapy with Bevacizumab (CB) for First-Line Treatment of KRAS Mutant Metastatic Colorectal Cancer in Community Oncology Settings
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Bevacizumab is a standard first-line (L1) treatment for metastatic colorectal cancer (mCRC) patients regardless of RAS status. This retrospective study examined treatment patterns and outcomes in a community oncology sample of KRAS mutant mCRC patients treated with chemotherapy (C) or C plus bevacizumab (CB) in L1.
This study used medical records from the Vector Oncology Data Warehouse. Eligible patients were confirmed KRAS mutant mCRC and received L1 C or CB. Kaplan-Meier analysis assessed L1 progression-free survival (PFS) and overall survival (OS). Cox regression models examined the interaction of tumor location (R/L) with treatment.
CB (n = 264) compared to C (n = 109) patients were younger, less likely performance status (PS) impaired, and more likely with liver metastases. Median unadjusted PFS was 10.41 months (95% CI 9.0–11.3) in CB and 7.66 months (95% CI 6.5–9.1) in C patients (p = 0.174). Median unadjusted OS was 26.91 months (95% CI 24.3–29.3) in CB and 23.33 months (95% CI 19.7–29.2) in C patients (p = 0.571). For patients with right- vs. left-sided tumors, C (but not CB)-treated patients had higher adjusted risk for progression (HR = 1.715, 95% CI 1.108, 2.653; p = 0.015).
CB- vs. C-treated KRAS mutant mCRC patients may have a meaningful PFS benefit. Patients with right-sided tumors treated with C were at higher risk for disease progression than patients with left-sided tumors. Tumor location had no significant effect on outcomes in the CB cohort.
KeywordsStandard chemotherapy backbones VEGF inhibitors Tumor location Overall survival Real world outcomes
This work was funded by Genentech, Inc.
Compliance with Ethical Standards
Conflict of Interest
SO and NS are employed by and own stock in Genentech, Inc. SSH and MW are consultants for Genentech. JH is on an advisory board for Genentech, with her institution receiving her honorarium. In addition, JH’s institution has received research support from Genentech. YZ has received travel support from Genentech. AH reported no conflicts of interest. Genentech sponsored this study and provided financial support for the conduct of the research and for preparation of the article. Genentech collaborated on the design of the study, interpretation of the analyses, and in the decision to submit the article for publication, but did not have a direct role in data collection, data analysis, or writing of the report.
Research Involving Human Participants
This research was reviewed and approved by IntegReview Institutional Review Board, in Austin, Texas. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
For this type of study, formal consent is not required.
Availability of Data and Material
Vector Oncology does not make datasets publicly available because study data are used under license from source practices. Vector Oncology will consider requests to access study datasets on a case-by-case basis.
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