The Lynx Group

Continuation of Bevacizumab Beyond Progression Improves Outcome in Patients with Metastatic Colorectal Cancer

October 2012, Vol 3, No 7

Vienna, Austria—More support for the continuation of treatment with bevacizumab beyond disease progression in patients with metastatic colorectal cancer was reported at the 2012 European Society for Medical Oncology (ESMO) Congress, validating a small but growing body of pre­vious data.

The phase 3 study, which was presented at the 2012 ESMO Congress by the Gruppo Oncologico Nord Ovest, randomized patients who had re­ceived bevacizumab plus first-line chemotherapy with a fluoropyrimidine (FOLFIRI [folinic acid, fluoro­uracil, irinotecan], FOLFOX [folinic acid, fluorouracil, oxaliplatin], or FOLFOXIRI [folinic acid, fluorouracil, irinotecan, oxaliplatin]) to receive a second line of chemotherapy using either FOLFOX or FOLFIRI alone (arm A) or together with bevacizu­mab (arm B).

In the intent-to-treat analysis of 184 patients followed for a median of 18 months, the median progression-free survival (PFS) was 4.97 months without bevacizumab and 6.77 months in patients who continued to receive the drug, representing a 35% reduction in the risk of progression, reported Gianluca Masi, MD, Medical Director of Oncology at the University Hospital of Pisa, Italy.

A PFS analysis that adjusted for various stratification factors, age, and sex confirmed that bevacizumab added to chemotherapy improved PFS versus chemotherapy alone by 30%. Overall survival data are not yet mature, with the control arm having 52 deaths and the bevacizumab arm having 46 deaths so far.

“This is the second randomized trial investigating the impact of bevacizumab continuation beyond first progression,” Dr Masi said. “The continuation of bevacizumab in combination with second-line chemo­­therapy represents a new treatment option.”

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