EXPERIENCE OF BEVACIZUMAB USE IN PATIENTS WITH INOPERABLE COLORECTAL CANCER IN KIROV REGION
https://doi.org/10.17650/2220-3478-2014-0-4-27-31
- Р Р‡.МессенРТвЂВВВВВВВВжер
- РћРТвЂВВВВВВВВнокласснРСвЂВВВВВВВВРєРСвЂВВВВВВВВ
- LiveJournal
- Telegram
- ВКонтакте
- РЎРєРѕРїРСвЂВВВВВВВВровать ссылку
Full Text:
Abstract
Purpose. To conduct retrospective analysis of treatment results of combined first line therapy of metastatic colorectal cancer with bevacizumab with further bevacizumab maintenance and second line treatment with or without bevacizumab use in Kirov regional clinical oncology dispensary.
Materials and methods. The study was conducted in Kirov regional clinical oncology dispensary from 2008 until 2014. 35 patients treated with combined first line therapy including bevacizumab with further bevacizumab maintenance and second line treatment with or without bevacizumab were retrospectively evaluated. Overall response was evaluated using RECIST ver. 1.1 criteria. Long term outcomes – progression free and overall survival were evaluated. Treatment safety was evaluated using NCI CTCAE.
Results. There were no complete remissions in second line bevacizumab treatment, partial remissions were detected for 4 (22.2 %) patients, stable disease for 14 (77.8 %). Median progression free survival in both groups was comparable 9.1 and 10.4 months respectively. Patients treated with bevacizumab in first and second lines of treatment had 8.2 months survival benefit (p > 0.05).
Conclusions. Combined first line therapy of metastatic colorectal cancer with bevacizumab with further bevacizumab maintenance and second line treatment with bevacizumab improves overall survival on 8.2 months in comparison with patients who stopped bevacizumab treatment after first disease progression.
About the Authors
N. Z. ShermanRussian Federation
M. S. Ramazanova
Russian Federation
Ye. N. Gopachenko
Russian Federation
References
1. Zlokachestvennye novoobrazovaniya v Rossii v 2012 godu (zabolevaemost' i smertnost'). Pod red. A.D. Kaprina, V.V. Starinskogo, G.V. Petrovoi. M.: FGBU «MNIOI im. P.A. Gertsena» Minzdrava Rossii, 2014. 250 s.
2. Raja F.A., Hook J.M., Ledermann J.A. Biomarkers in the development of antiangiogenic therapies for ovarian cancer. Cancer Treat Rev 2012;38:662-72.
3. Moghaddam M.S., Amini A., Morris D.L., Pourgholami M.H. Significance of vascular endothelial growth factor in growth and peritoneal dissemination of ovarian cancer. Cancer Metastasis Rev 2012;31:143-62.
4. Wu H.C., Li P.C. Proteins expressed on tumor endothelial cells as potential targets for anti-angiogenic therapy. J Cancer Molec 2008;4:17-22.
5. Giantonio B.J. Targeted therapies: Goldie-Coldman and bevacizumab beyond disease progression. Nat Rev Clin Oncol 2009;6: 311-2.
6. Melnyk O., Zimmerman M., Kim K.J., Shuman M. Neutralizing anti-vascular endothelial growth factor antibody inhibits further growth of established prostate cancer and metastases in a preclinical model. J Urol 1999;161:960-3.
7. Mesiano S., Ferrara N., Jaffe R.B. Role of vascular endothelial growth factor in ovarian cancer: inhibition of ascites formation by immunoneutralization. Am J Pathol 1998;153:1249-56.
8. Klement G., Baruchel S., Rak J. et al. Continuous low-dose therapy with vinblastine and VEGF receptor-2 antibody induces sustained tumor regression without overt toxicity. J Clin Invest 2000;105:R15-24.
9. Klement G., Huang P., Mayer B. et al. Differences in therapeutic indexes of combination metronomic chemotherapy and an anti-VEGFR-2 antibody in multidrugresistant human breast cancer xenografts. Clin Cancer Res 2002;8:221-32.
10. Hurwitz H., Fehrenbacher L., Novotny W. et al. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 2004;350: 2335-42.
11. Saltz L.B., Clarke S., Dnaz-Rubio E. et al. Bevacizumab in combination with oxaliplatinbased chemotherapy as first-line therapy in metastatic colorectal cancer: a randomized phase III study. J Clin Oncol 2008 Jun;26(12):2013-9.
12. Tebbutt N.C., Wilson K., Gebski V.J. et al. Capecitabine, bevacizumab, and mitomycin in first-line treatment of metastatic colorectal cancer: results of the Australasian Gastrointestinal Trials Group Randomized Phase III MAX Study. J Clin Oncol 2010;28(19):3191-8.
13. Cunningham D., Lang I., Marcuello E. et al. Bevacizumab plus capecitabine versus capecitabine alone in elderly patients with previously untreated metastatic colorectal cancer (AVEX): an open-label, randomized phase 3 trial. Lancet Oncol 2013;14(11): 1077-85.
14. Dnaz-Rubio E., Gumez-Espasa A., Massutn B. et al. First-line XELOX plus bevacizumab followed by XELOX plus bevacizumab or single-agent bevacizumab as maintenance therapy in patients with metastatic colorectal cancer: the phase III MACRO TTD study. Oncologist 2012;17(1):15-25.
15. Koopman M., Simkens L., MayA.M. et al. Final results and subgroup analyses of the phase 3 CAIRO3 study: Maintenance treatment with capecitabine and bevacizumab versus observation after induction treatment with chemotherapy and bevacizumab in metastatic colorectal cancer (mCRC). J Clin Oncol 2014;32(suppl 3; abstr LBA388).
16. Koopman M., Simkens L., MayA.M. et al. Final results and subgroup analyses of the phase 3 CAIRO3 study: Maintenance treatment with capecitabine and bevacizumab versus observation after induction treatment with chemotherapy and bevacizumab in metastatic colorectal cancer (mCRC). J Clin Oncol 2014;32:5s(suppl; abstr 3504).
17. Kozloff M., Yood M.U., Berlin J. et al. Clinical outcomes associated with bevacizumab containing treatment of metastatic colorectal cancer: the BRiTE observational cohort study. Oncologist 2009;14:862-70.
18. Bendell J.C., Bekaii-Saab T.S., Cohn A.L. et al. Treatment patterns and clinical outcomes in patients with metastatic colorectal cancer initially treated with FOLFOX-bevacizumab or FOLFIRI-bevacizumab: results from ARIES, a bevacizumab observational cohort study. Oncologist 2012;17:1486-95.
19. Bennouna J., Sastre J., Arnold D. et al. Continuation of bevacizumab after first progression in metastatic colorectal cancer (ML18147): a randomised phase 3 trial. Lancet Oncol 2013;14:29-37.
20. Grothey A., Sugrue M.M., Purdie D.M. et al. Bevacizumab beyond first progression is associated with prolonged overall survival in metastatic colorectal cancer: results from a large observational cohort study (BRiTE). J Clin Oncol 2008: 26:5326-34.
21. Cohn A.L., Bekaii-Saab T., Bendell J.C. et al. Clinical outcomes in bevacizumab (BV)-treated patients (pts) with metastatic colorectal cancer (mCRC): Results from ARIES observational cohort study (OCS) and confirmation of BRiTE data on BV beyond progression (BBP). J Clin Oncol 2010;28:15s (suppl; abstr 3596).
Review