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Bevacizumab plus chemotherapy as salvage treatment in chemorefractory patients with metastatic colorectal cancer

PURPOSE: The combination of chemotherapy and bevacizumab, a monoclonal antibody targeting the vascular endothelial growth factor, is consistently being used as first- and second-line treatment in patients with metastatic colorectal cancer (mCRC). There is little data of the activity of bevacizumab i...

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Autores principales: Geva, Ravit, Vecchione, Loredana, Tejpar, Sabine, Piessevaux, Hubert, Van Cutsem, Eric, Prenen, Hans
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3558253/
https://www.ncbi.nlm.nih.gov/pubmed/23378775
http://dx.doi.org/10.2147/OTT.S41383
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author Geva, Ravit
Vecchione, Loredana
Tejpar, Sabine
Piessevaux, Hubert
Van Cutsem, Eric
Prenen, Hans
author_facet Geva, Ravit
Vecchione, Loredana
Tejpar, Sabine
Piessevaux, Hubert
Van Cutsem, Eric
Prenen, Hans
author_sort Geva, Ravit
collection PubMed
description PURPOSE: The combination of chemotherapy and bevacizumab, a monoclonal antibody targeting the vascular endothelial growth factor, is consistently being used as first- and second-line treatment in patients with metastatic colorectal cancer (mCRC). There is little data of the activity of bevacizumab in chemorefractory mCRC patients. The aim of this retrospective single center study was to evaluate the activity of bevacizumab combined with chemotherapy in this study population. METHODS: Forty-six consecutive mCRC patients treated in the University Hospital Gasthuisberg (Leuven, Belgium) receiving bevacizumab in advanced lines following failure of conventional chemotherapy were included in this study. Treatment regimen consisted of bevacizumab 5 mg/kg in combination with leucovorin, 5-fluorouracil, and oxaliplatin (FOLFOX) or leucovorin, 5-fluorouracil, and irinotecan (FOLFIRI). RESULTS: Bevacizumab plus chemotherapy was used in third-line treatment in eight (17%) patients and in fourth-line treatment or more in 38 patients (83%). All patients previously failed irinotecan-based chemotherapy, 44 (96%) failed oxaliplatin-based regimens, and 40 (87%) failed treatment with cetuximab. Bevacizumab was given in combination with irinotecan-based chemotherapy in 36 patients, oxaliplatin-based chemotherapy in nine patients, and with single agent 5-fluorouracil in one patient. Objective response was demonstrated in ten patients (22%) and disease control in 38 (83%) with a median progression-free survival of 8.9 months and a median overall survival of 13.8 months. Only four patients experienced grade III and above bevacizumab-related toxicity. CONCLUSION: Taking into account the retrospective nature of the study which can influence the selection of patients, bevacizumab given in advanced lines after failure of conventional chemotherapy and antiepidermal growth factor receptor agents can result in high disease control rates in patients with mCRC.
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spelling pubmed-35582532013-02-01 Bevacizumab plus chemotherapy as salvage treatment in chemorefractory patients with metastatic colorectal cancer Geva, Ravit Vecchione, Loredana Tejpar, Sabine Piessevaux, Hubert Van Cutsem, Eric Prenen, Hans Onco Targets Ther Original Research PURPOSE: The combination of chemotherapy and bevacizumab, a monoclonal antibody targeting the vascular endothelial growth factor, is consistently being used as first- and second-line treatment in patients with metastatic colorectal cancer (mCRC). There is little data of the activity of bevacizumab in chemorefractory mCRC patients. The aim of this retrospective single center study was to evaluate the activity of bevacizumab combined with chemotherapy in this study population. METHODS: Forty-six consecutive mCRC patients treated in the University Hospital Gasthuisberg (Leuven, Belgium) receiving bevacizumab in advanced lines following failure of conventional chemotherapy were included in this study. Treatment regimen consisted of bevacizumab 5 mg/kg in combination with leucovorin, 5-fluorouracil, and oxaliplatin (FOLFOX) or leucovorin, 5-fluorouracil, and irinotecan (FOLFIRI). RESULTS: Bevacizumab plus chemotherapy was used in third-line treatment in eight (17%) patients and in fourth-line treatment or more in 38 patients (83%). All patients previously failed irinotecan-based chemotherapy, 44 (96%) failed oxaliplatin-based regimens, and 40 (87%) failed treatment with cetuximab. Bevacizumab was given in combination with irinotecan-based chemotherapy in 36 patients, oxaliplatin-based chemotherapy in nine patients, and with single agent 5-fluorouracil in one patient. Objective response was demonstrated in ten patients (22%) and disease control in 38 (83%) with a median progression-free survival of 8.9 months and a median overall survival of 13.8 months. Only four patients experienced grade III and above bevacizumab-related toxicity. CONCLUSION: Taking into account the retrospective nature of the study which can influence the selection of patients, bevacizumab given in advanced lines after failure of conventional chemotherapy and antiepidermal growth factor receptor agents can result in high disease control rates in patients with mCRC. Dove Medical Press 2013-01-25 /pmc/articles/PMC3558253/ /pubmed/23378775 http://dx.doi.org/10.2147/OTT.S41383 Text en © 2013 Geva et al, publisher and licensee Dove Medical Press Ltd This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.
spellingShingle Original Research
Geva, Ravit
Vecchione, Loredana
Tejpar, Sabine
Piessevaux, Hubert
Van Cutsem, Eric
Prenen, Hans
Bevacizumab plus chemotherapy as salvage treatment in chemorefractory patients with metastatic colorectal cancer
title Bevacizumab plus chemotherapy as salvage treatment in chemorefractory patients with metastatic colorectal cancer
title_full Bevacizumab plus chemotherapy as salvage treatment in chemorefractory patients with metastatic colorectal cancer
title_fullStr Bevacizumab plus chemotherapy as salvage treatment in chemorefractory patients with metastatic colorectal cancer
title_full_unstemmed Bevacizumab plus chemotherapy as salvage treatment in chemorefractory patients with metastatic colorectal cancer
title_short Bevacizumab plus chemotherapy as salvage treatment in chemorefractory patients with metastatic colorectal cancer
title_sort bevacizumab plus chemotherapy as salvage treatment in chemorefractory patients with metastatic colorectal cancer
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3558253/
https://www.ncbi.nlm.nih.gov/pubmed/23378775
http://dx.doi.org/10.2147/OTT.S41383
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