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Maintenance of angiogenesis inhibition with aflibercept after progression to bevacizumab in metastatic colorectal cancer: real life study in the Valencian community

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Abstract

Introduction

The second-line chemotherapy in metastatic colorectal cancer (mCRC) with FOLFIRI-aflibercept demonstrated an increase in survival compared with FOLFIRI in patients previously treated with oxaliplatin-based regimens. Few data are available in patients treated previously with bevacizumab. Our objective is to evaluate the efficacy and safety of FOLFIRI-aflibercept in second-line treatment in patients who have previously received bevacizumab.

Patients and methods

This is a observational, retrospective study of patients with mCRC treated with FOLFIRI-aflibercept in 2nd line in eight hospitals in the Valencian Community. Survival, response, and toxicity were analyzed.

Results

122 patients with a median age of 61 years were included. 89% of patients had PS 0–1. The median of PFS (progression free survival) and OS (overall survival) was 5.45 (95% CI 4.74–6.15 months) and 10.15 (95% CI 7.47–12.82 months), respectively. Disease control rate 59.8%. The most common grade 3–4 adverse events were neutropenia (13,1%) and asthenia (9%). The presence of hypertension during treatment with FOLFIRI-aflibercept was associated with a survival benefit. Median of OS was 14.45 (95% CI 11.58–17.32) in patients with hypertension vs 7.78 (95% CI 5.02–10.54) in patients without hypertension (p = .001). Our results suggest that the presence of PS 0, primary tumor surgery, metachronous metastases, and the presence of only 1 metastatic location, are favorable prognostic factors associated with better OS.

Conclusions

Our results confirm the value of maintaining angiogenesis inhibition with FOLFIRI-aflibercept in mCRC after progression to a first-line treatment with bevacizumab. The development of hypertension during treatment is a possible predictive marker of response.

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Data availability statement

The data of this study are available.

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Funding

The authors did not receive support from any organization for the submitted work. No funding was received to assist with the preparation of this manuscript. No funding was received for conducting this study. No funds, grants, or other support was received.

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Authors and Affiliations

  1. Medical Oncology Department, CIBERONC, Hospital General Universitario de Valencia, Valencia, Spain

    Mireia Gil Raga

  2. Medical Oncology Department, Hospital Provincial de Castellón, Castellón, Spain

    Irene Paredero Pérez & Isabel Busquier Hernández

  3. Medical Oncology Department, Hospital Universitario Doctor Peset de Valencia, Valencia, Spain

    Rebeca Chulvi Veiga

  4. Medical Oncology Department, Fundación Instituto Valenciano de Oncología, Valencia, Spain

    Marcos Melian Sosa

  5. Medical Oncology Department, CIBERONC, Hospital General Universitario de Valencia, Universitat de València, Valencia, Spain

    Maria José Safont Aguilera

  6. Medical Oncology Department, Hospital Arnau de Vilanova, Valencia, Spain

    Paula Llor Rodríguez

  7. Medical Oncology Department, Hospital Universitario de La Ribera, Alzira, Spain

    María Teresa Taberner Bonastre

  8. Medical Oncology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain

    Jorge Aparicio Urtasun

  9. Medical Oncology Department, Hospital de Sagunto, Sagunto, Spain

    Laura Palomar Abad

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  1. Mireia Gil Raga
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Correspondence to Mireia Gil Raga.

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All procedures performed in our study were in accordance with the ethical standards of the Ethical committee for drug research of Hospital General de Valencia and Hospital Provincial de Castellón, and with the 1964 Helsinki declaration and its latier amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Raga, M.G., Pérez, I.P., Veiga, R.C. et al. Maintenance of angiogenesis inhibition with aflibercept after progression to bevacizumab in metastatic colorectal cancer: real life study in the Valencian community. Clin Transl Oncol 25, 1455–1462 (2023). https://doi.org/10.1007/s12094-022-03047-8

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