TY - JOUR
T1 - Evaluation of second-line anti-VEGF after first-line anti-EGFR based therapy in RAS wild-type metastatic colorectal cancer
T2 - The multicenter “SLAVE” study
AU - Parisi, Alessandro
AU - Cortellini, Alessio
AU - Cannita, Katia
AU - Venditti, Olga
AU - Camarda, Floriana
AU - Calegari, Maria Alessandra
AU - Salvatore, Lisa
AU - Tortora, Giampaolo
AU - Rossini, Daniele
AU - Germani, Marco Maria
AU - Boccaccino, Alessandra
AU - Dell’aquila, Emanuela
AU - Fulgenzi, Claudia
AU - Santini, Daniele
AU - De Tursi, Michele
AU - Tinari, Nicola
AU - Di Marino, Pietro
AU - Lombardi, Pasquale
AU - Keränen, Susana Roselló
AU - Álvaro, Marisol Huerta
AU - Zurlo, Ina Valeria
AU - Corsi, Domenico Cristiano
AU - Emiliani, Alessandra
AU - Zanaletti, Nicoletta
AU - Troiani, Teresa
AU - Vitale, Pasquale
AU - Giampieri, Riccardo
AU - Merloni, Filippo
AU - Occhipinti, Mario Alberto
AU - Marchetti, Paolo
AU - Roberto, Michela
AU - Mazzuca, Federica
AU - Ghidini, Michele
AU - Indini, Alice
AU - Garajova, Ingrid
AU - Zoratto, Federica
AU - Monache, Simona Delle
AU - Porzio, Giampiero
AU - Ficorella, Corrado
PY - 2020/5
Y1 - 2020/5
N2 - Background: The optimal anti-angiogenic strategy as second-line treatment in RAS wild-type metastatic colorectal cancer (mCRC) treated with anti-EGFR (Epidermal Growth Factor Receptor) based first-line treatment is still debated. Methods: This multicenter, real-world, retrospective study is aimed at evaluating the effectiveness of second-line Bevacizumab-and Aflibercept-based treatments after an anti-EGFR based first-line regimen. Clinical outcomes measured were: objective response rate (ORR), progression free survival (PFS), overall survival (OS) and adverse events (AEs) profiles. Results: From February 2011 to October 2019, 277 consecutive mCRC patients received Bevacizumab-based (228, 82.3%) or Aflibercept-based (49, 17.7%) regimen. No significant difference was found regarding ORR. The median follow-up was 27.7 months (95%CI: 24.7–34.4). Aflibercept-treated group had a significantly shorter PFS compared to Bevacizumab-treated group (5.6 vs. 7.1 months, respectively) (HR = 1.34 (95%CI: 0.95–1.89); p = 0.0932). The median OS of the Bevacizumab-treated group and Aflibercept-treated group was 16.2 (95%CI: 15.3–18.1) and 12.7 (95%CI: 8.8–17.5) months, respectively (HR= 1.31 (95%CI: 0.89–1.93) p = 0.16). After adjusting for the key covariates (age, gender, performance status, number of metastatic sites and primary tumor side) Bevacizumab-based regimens revealed to be significantly related with a prolonged PFS (HR = 1.44 (95%CI: 1.02–2.03); p = 0.0399) compared to Aflibercept-based regimens, but not with a prolonged OS (HR = 1.47 (95%CI: 0.99–2.17); p = 0.0503). The incidence of G3/G4 VEGF inhibitors class-specific AEs was 7.5% and 26.5% in the Bevacizumab-treated group and the Aflibercept-treated group, respectively (p = 0.0001). Conclusion: Our analysis seems to reveal that Bevacizumab-based regimens have a slightly better PFS and class-specific AEs profile compared to Aflibercept-based regimen as second-line treatment of RAS wild-type mCRC patients previously treated with anti-EGFR based treatments. These results have to be taken with caution and no conclusive considerations are allowed.
AB - Background: The optimal anti-angiogenic strategy as second-line treatment in RAS wild-type metastatic colorectal cancer (mCRC) treated with anti-EGFR (Epidermal Growth Factor Receptor) based first-line treatment is still debated. Methods: This multicenter, real-world, retrospective study is aimed at evaluating the effectiveness of second-line Bevacizumab-and Aflibercept-based treatments after an anti-EGFR based first-line regimen. Clinical outcomes measured were: objective response rate (ORR), progression free survival (PFS), overall survival (OS) and adverse events (AEs) profiles. Results: From February 2011 to October 2019, 277 consecutive mCRC patients received Bevacizumab-based (228, 82.3%) or Aflibercept-based (49, 17.7%) regimen. No significant difference was found regarding ORR. The median follow-up was 27.7 months (95%CI: 24.7–34.4). Aflibercept-treated group had a significantly shorter PFS compared to Bevacizumab-treated group (5.6 vs. 7.1 months, respectively) (HR = 1.34 (95%CI: 0.95–1.89); p = 0.0932). The median OS of the Bevacizumab-treated group and Aflibercept-treated group was 16.2 (95%CI: 15.3–18.1) and 12.7 (95%CI: 8.8–17.5) months, respectively (HR= 1.31 (95%CI: 0.89–1.93) p = 0.16). After adjusting for the key covariates (age, gender, performance status, number of metastatic sites and primary tumor side) Bevacizumab-based regimens revealed to be significantly related with a prolonged PFS (HR = 1.44 (95%CI: 1.02–2.03); p = 0.0399) compared to Aflibercept-based regimens, but not with a prolonged OS (HR = 1.47 (95%CI: 0.99–2.17); p = 0.0503). The incidence of G3/G4 VEGF inhibitors class-specific AEs was 7.5% and 26.5% in the Bevacizumab-treated group and the Aflibercept-treated group, respectively (p = 0.0001). Conclusion: Our analysis seems to reveal that Bevacizumab-based regimens have a slightly better PFS and class-specific AEs profile compared to Aflibercept-based regimen as second-line treatment of RAS wild-type mCRC patients previously treated with anti-EGFR based treatments. These results have to be taken with caution and no conclusive considerations are allowed.
KW - Aflibercept
KW - Anti-angiogenics
KW - Bevacizumab
KW - Cetuximab
KW - Panitumumab
KW - RAS wild-type mCRC
KW - Second-line treatment
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U2 - 10.3390/cancers12051259
DO - 10.3390/cancers12051259
M3 - Article
AN - SCOPUS:85085143774
VL - 12
JO - Cancers
JF - Cancers
SN - 2072-6694
IS - 5
M1 - 1259
ER -