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An observational cohort study of bevacizumab and chemotherapy in metastatic colorectal cancer patients: safety and efficacy with analysis by age group

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Abstract

Bevacizumab improves survival when added to chemotherapy in metastatic colorectal cancer (mCRC). We assessed the safety and efficacy of bevacizumab in mCRC patients ≥70 years old (YO) vs. those <70 YO. mCRC patients treated from 2005–2012 who received chemotherapy (physician’s choice) plus bevacizumab were included. The primary end point was safety; secondary objectives were progression-free survival (PFS) and overall survival (OS). Data was collected retrospectively. Three-hundred eight patients (92 ≥70 YO, 216 <70 YO) with 20.5 month median follow-up were included. Of the patients, 1.9 % died due to bevacizumab-related adverse effects; all were <70 YO. Grades 3–5 adverse events of interest for bevacizumab in patients ≥70 YO included hypertension (37.0 %), venous thromboembolism (6.5 %), wound-healing complications (5.4 %), bleeding (7.6 %), fistula (4.3 %), arterial thromboembolism (3.3 %), congestive heart failure (2.2 %), and proteinuria (grades 1–2 only, 14.1 %). Treatment was stopped due to adverse effects in 6.0 % of older patients. Older patients had significantly more ischemic heart disease and hypertension at baseline, and were treated less with FOLFOX and more with 5FU/LV monotherapy; nevertheless, OS and PFS were similar in younger and older patients. Compared to younger patients, in older patients, rates of proteinuria (all grades 1–2) were significantly higher (14.1 vs. 5.6 %, p=0.012) and rates of treatment-related hypertension (grades 3–5) were marginally higher (37 vs. 25.9 %, p=0.053); rates of other adverse events were similar in the two groups. In our patient population, bevacizumab was safe and effective in older as well as younger patients.

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Conflict of interest

Dr. A, Dr. B, Dr. C, Dr. D, and Dr. F have nothing to disclose. Dr. E and Dr. G report personal fees outside the submitted work.

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Authors and Affiliations

  1. Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, P.O. box 12000, Jerusalem, Israel, 91120

    Esther Tahover, Ayala Hubert, Mark Temper, Azzam Salah, Tamar Peretz, Tamar Hamburger & Beatrice Uziely

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  1. Esther Tahover
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  2. Ayala Hubert
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  3. Mark Temper
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  4. Azzam Salah
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Correspondence to Esther Tahover.

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Esther Tahover and Ayala Hubert contributed equally.

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Tahover, E., Hubert, A., Temper, M. et al. An observational cohort study of bevacizumab and chemotherapy in metastatic colorectal cancer patients: safety and efficacy with analysis by age group. Targ Oncol 10, 55–63 (2015). https://doi.org/10.1007/s11523-014-0311-3

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  • DOI: https://doi.org/10.1007/s11523-014-0311-3

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