TY - JOUR
T1 - Bevacizumab treatment in the elderly patient with metastatic colorectal cancer
AU - Bartolomeo, Maria Di
AU - Maggi, Claudia
AU - Ricchini, Francesca
AU - Pietrantonio, Filippo
AU - Iacovelli, Roberto
AU - de Braud, Filippo
AU - Inno, Alessandro
PY - 2015/1/5
Y1 - 2015/1/5
N2 - Metastatic colorectal cancer (mCRC), like many cancers, is primarily a disease of elderly people. Despite this prevalence, such patients are often excluded from randomized trials or represent a minority of enrolled patients. Moreover, the criteria for establishing benefit or side effects of treatment strategies in this population are uncertain and not well recognized. Bevacizumab improves the outcome of mCRC when used in combination with standard first-line and second-line chemotherapy and beyond the first disease progression when given with a chemotherapy backbone different from that used in the precedent line. The particular toxicity profile of this antiangiogenesis agent (in particular hypertension, thromboembolic events, hemorrhage, and renal failure) may discourage its use in elderly patients with comorbidities. Data from subgroup analyses of randomized trials and the results of recent cohort studies suggest a significant benefit from the addition of bevacizumab to standard chemotherapy for elderly patients comparable with that observed in younger patients, except for the increased risk for thromboembolic events. Age alone should not be a barrier to use of bevacizumab, and further research with a more complete geriatric assessment should investigate the role of bevacizumab in elderly patients with mCRC to avoid undertreatment of this patient population due to a historical conservative approach.
AB - Metastatic colorectal cancer (mCRC), like many cancers, is primarily a disease of elderly people. Despite this prevalence, such patients are often excluded from randomized trials or represent a minority of enrolled patients. Moreover, the criteria for establishing benefit or side effects of treatment strategies in this population are uncertain and not well recognized. Bevacizumab improves the outcome of mCRC when used in combination with standard first-line and second-line chemotherapy and beyond the first disease progression when given with a chemotherapy backbone different from that used in the precedent line. The particular toxicity profile of this antiangiogenesis agent (in particular hypertension, thromboembolic events, hemorrhage, and renal failure) may discourage its use in elderly patients with comorbidities. Data from subgroup analyses of randomized trials and the results of recent cohort studies suggest a significant benefit from the addition of bevacizumab to standard chemotherapy for elderly patients comparable with that observed in younger patients, except for the increased risk for thromboembolic events. Age alone should not be a barrier to use of bevacizumab, and further research with a more complete geriatric assessment should investigate the role of bevacizumab in elderly patients with mCRC to avoid undertreatment of this patient population due to a historical conservative approach.
KW - Antivascular treatment
KW - Bevacizumab
KW - Elderly
KW - Metastatic colorectal cancer
KW - Review
UR - http://www.scopus.com/inward/record.url?scp=84920509530&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84920509530&partnerID=8YFLogxK
U2 - 10.2147/CIA.S54675
DO - 10.2147/CIA.S54675
M3 - Article
C2 - 25584021
AN - SCOPUS:84920509530
VL - 10
SP - 127
EP - 133
JO - Clinical Interventions in Aging
JF - Clinical Interventions in Aging
SN - 1176-9092
ER -