Maintenance of angiogenesis inhibition with aflibercept after progression to bevacizumab in metastatic colorectal cancer: real life study in the Valencian community
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Mireia Gil Raga [1] ; Irene Paredero Pérez [6] ; Rebeca Chulvi Veiga [2] ; Marcos Melian Sosa [3] ; Maria José Safont Aguilera [1] ; Paula Llor Rodríguez [4] ; María Teresa Taberner Bonastre [7] ; Jorge Aparicio Urtasun [8] ; Laura Palomar Abad [5] ; Isabel Busquier Hernández [6]
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[1] Hospital General Universitario de Valencia
Hospital General Universitario de Valencia
Valencia, España
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[2] Hospital Universitario Doctor Peset
Hospital Universitario Doctor Peset
Valencia, España
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[3] Instituto Valenciano de Oncologia
Instituto Valenciano de Oncologia
Valencia, España
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[4] Hospital Arnau de Vilanova
Hospital Arnau de Vilanova
Valencia, España
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[5] Hospital de Sagunto
Hospital de Sagunto
Sagunto/Sagunt, España
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[6] Servicio de Oncología Médica, Hospital Provincial de Castellón, Castellón, España
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[7] Servicio de Oncología Médica, Hospital Universitario de La Ribera, Alzira, España
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[8] Servicio de Oncología Médica, Hospital Universitario y Politécnico La Fe, Valencia, España
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- Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 25, Nº. 5 (May), 2023, págs. 1455-1462
- Idioma: inglés
- Texto completo no disponible (Saber más ...)
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Resumen
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.
