Colorectal Cancer Coverage from Every Angle

Second-Line Treatment Alternatives for Metastatic Colorectal Cancer

By: Joshua D. Madera, MS
Posted: Wednesday, July 29, 2020

For patients with RAS wild-type metastatic colorectal cancer, treatment with bevacizumab or aflibercept may prove to be effective second-line therapies with similar efficacy and activity, according to the results of the multicenter retrospective SLAVE study, presented during the European Society for Medical Oncology (ESMO) World Congress on Gastrointestinal Cancer 2020 Virtual (ESMO World GI; Abstract P-168). However, aflibercept-based therapy was reported to be associated with more adverse events than bevacizumab-based therapy, according to Corrado Ficorella, MD, of the University of L’Aquila, Italy, and colleagues.

“Further analyses with [a] larger sample size and a prospective design are certainly needed to better define and personalize the antiangiogenic strategy as second-line treatment in wild-type metastatic colorectal cancer,” the investigators concluded.

From 2011 to 2019, a total of 277 patients with RAS wild-type metastatic colorectal cancer were enrolled in the study. All patients received first-line therapy with panitumumab or cetuximab. Patients also received second-line regimens with bevacizumab (82.3%) or aflibercept (17.7%) for the duration of the study.

The investigators reported that at the median follow-up of 43.2 months, the progression-free survival with bevacizumab- and aflibercept-based treatment was 7.1 and 5.6 months, respectively. In addition, the overall survival for bevacizumab- and aflibercept-based treatment was 16.2 and 12.7 months, respectively. The objective response rate was 45.2% and 30.6% with bevacizumab- and aflibercept-based therapy, respectively.

Furthermore, the rates of grade 1 or 2 and grade 3 or 4 class-specific adverse effects were 23.7% and 7.5% for bevacizumab-based treatment and 32.7% and 26.5% for aflibercept-based treatment, respectively. The rates of grade 1 or 2 and grade 3 or 4 hematologic adverse effects for bevacizumab-based and aflibercept-based treatment were 36.4% and 4.4%, as well as 59.2% and 10.2%, respectively. Moreover, nonclass-specific and nonhematologic adverse effects were reported for bevacizumab-based and aflibercept-based therapies.

Disclosure: The presenting author reported no conflicts of interest.

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