Bevacizumab Plus Chemotherapy as First-Line Treatment for Patients with Metastatic Colorectal Cancer: Results from a Spanish Observational Study

• Pedro Salinas Hernández

  Oncology Service, Hospital La Zarzuela Sanitas, Madrid, Spain

• Rafael Trujillo Vilchez

  Oncology Service, Hospital Santa Elena, Málaga, Spain

• Antonio Arriví García-Ramos

  Oncology Service, Hospital Son Llatzer, Palma de Mallorca, Spain

• Rosana Grande Ladron de Guevara

  Oncology Service, Hospital de Tudela, Navarra, Spain

• Angeles Rodríguez Jaraiz

  Oncology Service, Hospital San Pedro de Alcántara. Cáceres, Spain

• Pedro Gallurt Moreira

  Oncology Service, Universitario Puerto Real, Oncology Service, Cadiz, Spain

• Jose Maria Vieitez de Prado

  Oncology Service, Hospital Universitario Central de Asturias, Oviedo, Spain

• Miguel Ruiz López de Tejada

  Oncology Service, Hospital Punta de Europa, Algeciras, Spain

• Antonio Irigoyen Medina

  Oncology Service, Hospital Virgen de las Nieves, Granada, Spain

• Juan Manuel Campos Cervera

  Oncology Service, Hospital Arnau de Villanova, Valencia, Spain

• Juan Carlos Cámara Vicario

  Oncology Service, Hospital de Alcorcon, Madrid, Spain

• Uriel Bohn Sarmiento

  Oncology Service, Hospital Dr Negrín, Las Palmas de Gran Canaria, Spain

• Pedro López Tendero

  Oncology Service, Hospital de Xativa (Luis Alcañiz), Valencia, Spain

• Juan Domingo Alonso Lajara

  Oncology Service, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain

• Ana León Carbonero

  Oncology Service, Fundación Jímenez Díaz, Madrid, Spain

• Marisa García de Paredes

  Oncology Service, Hospital Universitario Ramon y Cajal, Madrid, Spain

• Juan de Alvaro Liaño

  Oncology Service, Hospital La Línea de la Concepción, Cadiz, Spain

• Asunción Juarez Marroquí

  Oncology Service, Hospital General de Elda, Alicante, Spain

• Luis López Gómez

  Oncology Service, Hospital Universitario Virgen de la Salud, Toledo, Spain

• Diego Soto de Prado Otero

  Oncology Service, Hospital Universitario de Valladolid, Valladolid, Spain

 Background: This observational study evaluated the efficacy and safety of treatment with bevacizumab plus chemotherapy until disease progression (PD) in Spanish patients with metastatic colorectal cancer (mCRC).

Methods: This multicentre, retrospective, observational analysis included patients receiving bevacizumab plus fluoropyrimidine-based chemotherapy as first-line treatment for mCRC who then developed PD. All patients received treatment in hospital oncology departments and none received bevacizumab as part of a clinical trial. Patients discontinuing treatment with bevacizumab for reasons other than PD were excluded. The primary endpoint was PFS; secondary endpoints were overall response rate (ORR) and safety.

Results: Overall, 165 patients were evaluable for analysis: median age 63.0 years; male/female 62%/38%; ECOG performance status 0/1/2 55%/43%/2%. Median duration of bevacizumab treatment was 8.7 months. ORR was 48.5% (6 complete and 74 partial responses) and disease control rate was 74%. Median progression-free survival (PFS) was 8.4 months (95% CI 7.2-9.6). Patients receiving oxaliplatin- or irinotecan-based regimens had median PFS of 9.2 and 7.7 months, respectively; those receiving treatment not containing either oxaliplatin or irinotecan had a median PFS of 6.1 months. KRAS status did not have a statistically significant effect on PFS (9.5 vs. 7.8 months for KRAS wild-type vs. mutant tumours, respectively; p=0.647) or ORR (44.8% vs. 52.6%, respectively; p=0.391). The most common grade 3/4 adverse events were: diarrhoea (7%), paraesthesia (7%), neutropenia (3%), cutaneous toxicity (2%), and thrombocytopenia (2%).

Conclusions: Treatment with bevacizumab plus standard chemotherapy is an effective and well-tolerated option for patients with mCRC who continue treatment until PD.

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