Maintenance of angiogenesis inhibition with aflibercept after progression to bevacizumab in metastatic colorectal cancer: real life study in the Valencian community.

Autor: Raga MG; Medical Oncology Department, CIBERONC, Hospital General Universitario de Valencia, Valencia, Spain. mir_gil@hotmail.com., Pérez IP; Medical Oncology Department, Hospital Provincial de Castellón, Castellón, Spain., Veiga RC; Medical Oncology Department, Hospital Universitario Doctor Peset de Valencia, Valencia, Spain., Sosa MM; Medical Oncology Department, Fundación Instituto Valenciano de Oncología, Valencia, Spain., Aguilera MJS; Medical Oncology Department, CIBERONC, Hospital General Universitario de Valencia, Universitat de València, Valencia, Spain., Rodríguez PL; Medical Oncology Department, Hospital Arnau de Vilanova, Valencia, Spain., Bonastre MTT; Medical Oncology Department, Hospital Universitario de La Ribera, Alzira, Spain., Urtasun JA; Medical Oncology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain., Abad LP; Medical Oncology Department, Hospital de Sagunto, Sagunto, Spain., Hernández IB; Medical Oncology Department, Hospital Provincial de Castellón, Castellón, Spain.
Jazyk: angličtina
Zdroj: Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico [Clin Transl Oncol] 2023 May; Vol. 25 (5), pp. 1455-1462. Date of Electronic Publication: 2023 Feb 01.
DOI: 10.1007/s12094-022-03047-8
Abstrakt: Introduction: The second-line chemotherapy in metastatic colorectal cancer (mCRC) with FOLFIRI-aflibercept demonstrated an increase in survival compared with FOLFIRI in patients previously treated with oxaliplatin-based regimens. Few data are available in patients treated previously with bevacizumab. Our objective is to evaluate the efficacy and safety of FOLFIRI-aflibercept in second-line treatment in patients who have previously received bevacizumab.
Patients and Methods: This is a observational, retrospective study of patients with mCRC treated with FOLFIRI-aflibercept in 2nd line in eight hospitals in the Valencian Community. Survival, response, and toxicity were analyzed.
Results: 122 patients with a median age of 61 years were included. 89% of patients had PS 0-1. The median of PFS (progression free survival) and OS (overall survival) was 5.45 (95% CI 4.74-6.15 months) and 10.15 (95% CI 7.47-12.82 months), respectively. Disease control rate 59.8%. The most common grade 3-4 adverse events were neutropenia (13,1%) and asthenia (9%). The presence of hypertension during treatment with FOLFIRI-aflibercept was associated with a survival benefit. Median of OS was 14.45 (95% CI 11.58-17.32) in patients with hypertension vs 7.78 (95% CI 5.02-10.54) in patients without hypertension (p = .001). Our results suggest that the presence of PS 0, primary tumor surgery, metachronous metastases, and the presence of only 1 metastatic location, are favorable prognostic factors associated with better OS.
Conclusions: Our results confirm the value of maintaining angiogenesis inhibition with FOLFIRI-aflibercept in mCRC after progression to a first-line treatment with bevacizumab. The development of hypertension during treatment is a possible predictive marker of response.
(© 2023. The Author(s), under exclusive licence to Federación de Sociedades Españolas de Oncología (FESEO).)
Databáze: MEDLINE
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