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Open Access 01-05-2014 | Colorectal Cancer

Bevacizumab Efficacy in Metastatic Colorectal Cancer is Dependent on Primary Tumor Resection

Authors: Francois Ghiringhelli, MD, PhD, Damien Bichard, PharmD, Samuel Limat, PharmD, Veronique Lorgis, MD, Julie Vincent, MD, PhD, Christophe Borg, MD, PhD, Julie Berthou, PharmD, David Orry, MD, Pablo Ortega-Deballon, MD, PhD, Zaher Lakkis, MD, Olivier Facy, MD, PhD, Bruno Heyd, MD, Patrick Rat, MD, Virginie Nerich, PharmD, Sylvain Ladoire, MD, PhD

Published in: Annals of Surgical Oncology | Issue 5/2014

Abstract

Purpose

Bevacizumab plus fluoropyrimidine-based chemotherapy is standard treatment for first-line and second-line metastatic colorectal cancer (mCRC). However, to date, there is no current biomarker predictive for the benefit of bevacizumab use for these patients. Preclinical data suggest that the presence of the primary tumor could be involved in less efficient antitumor activity of antiangiogenic agents, but no clinical data currently support this hypothesis.

Methods

We performed a retrospective analysis of factors associated with overall survival (OS) in a study cohort of 409 mCRC patients. Univariate and multivariate Cox proportional hazard regression models were used to assess the influence of primary tumor resection and bevacizumab use on OS. We evaluated associations linking bevacizumab use and OS among patients who previously underwent or did not undergo primary tumor resection. Results were externally validated in a second independent cohort of 328 mCRC patients.

Results

In the study cohort, bevacizumab use and resection of the primary tumor were associated with improved OS. However, subgroup analyses indicate that bevacizumab did not influence survival of patients bearing a primary colorectal tumor (hazard ratio (HR) 0.98, 95 % confidence interval (CI) 0.60–1.61, log-rank test P = 0.6). By contrast, the survival benefit of bevacizumab was restricted to patients who previously underwent primary tumor resection (HR 0.71, 95 % CI 0.55–0.92, P = 0.009). Similar results were observed in the validation cohort.

Conclusions

Addition of bevacizumab to chemotherapy is associated with improvement of OS only in patients with primary tumor resection. These data support the rationale to validate prospectively the influence of primary tumor resection on bevacizumab antitumor effect in synchronous mCRC.

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Title: Bevacizumab Efficacy in Metastatic Colorectal Cancer is Dependent on Primary Tumor Resection
Authors: Francois Ghiringhelli, MD, PhD
Damien Bichard, PharmD
Samuel Limat, PharmD
Veronique Lorgis, MD
Julie Vincent, MD, PhD
Christophe Borg, MD, PhD
Julie Berthou, PharmD
David Orry, MD
Pablo Ortega-Deballon, MD, PhD
Zaher Lakkis, MD
Olivier Facy, MD, PhD
Bruno Heyd, MD
Patrick Rat, MD
Virginie Nerich, PharmD
Sylvain Ladoire, MD, PhD
Publication date: 01-05-2014
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue 5/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-013-3463-y

2024 ASCO Annual Meeting

Springer Medicine

Bevacizumab Efficacy in Metastatic Colorectal Cancer is Dependent on Primary Tumor Resection

Abstract

Purpose

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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