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Bevacizumab and Chemotherapy in Elderly Patients With Untreated Metastatic Colorectal Cancer

By: Andrew Goldstein
Posted: Thursday, March 22, 2018

The monoclonal antibody bevacizumab, together with first-line chemotherapy, seems to be both safe and efficacious in older patients with metastatic colorectal cancer, according to the phase II PRODIGE 20 study  . Thomas Aparicio, MD, PhD, of the Assistance Publique Hôpitaux de Paris (APHP), and colleagues published their findings in the Annals of Oncology.

A total of 102 patients between the ages of 75 and 91 (median, 80 years) with untreated metastatic colorectal cancer were randomized to one of two treatment groups: bevacizumab plus chemotherapy or chemotherapy alone. The chemotherapy regimens included LV5FU2 (fluorouracil, folinic acid, cisplatin), FOLFOX (folinic acid, fluorouracil, oxaliplatin), and FOLFIRI (folinic acid, fluorouracil, irinotecan).

The best objective tumor response rate was 37.2% in those who received bevacizumab and 32.6% in those who received chemotherapy alone. The median progression–free survival was 9.7 months with bevacizumab compared with 7.8 months with chemotherapy alone.

The primary endpoint was met for efficacy in 50% of those treated with bevacizumab and in 58% of those treated with chemotherapy alone. The safety endpoint (absence of severe cardiovascular toxicities and unexpected hospitalization) was met in 61% of those in the bevacizumab group and in 71% of those in the chemotherapy-alone group. Most patients had no unexpected hospitalization, and few severe cardiovascular toxicities were observed in both arms during the first 4 months of treatment. The researchers are interested in conducting a phase III trial.




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