Source: DGNews  |  Posted 2 years ago

By Jenny Powers

BARCELONA, Spain -- June 26, 2009 -- Older patients with metastatic colorectal cancer do not suffer a greater degree of toxicity from treatment with bevacizumab, according to an analysis presented here at the 11th World Gastrointestinal Cancer Congress of the European Society for Medical Oncology (ESMO-GI).

Eric Van Cutsem, MD, University Hospital Gasthuisberg, Leuven, Belgium, presented data on June 25 from an analysis comparing the clinical benefit of bevacizumab in 3 age-based populations of patients with metastatic colorectal cancer.

Even though most patients with metastatic colorectal cancer are aged >65 years, this age group is underrepresented in randomised clinical trials, thus treatment benefit to older patients is often undetermined.

The researchers conducted a subgroup analysis of the Bevacizumab Expanded Access Trial (BEAT) data to determine the safety and efficacy of bevacizumab plus chemotherapy in older patients.

The BEAT study enrolled 1,914 patients of whom 50% received bevacizumab plus oxaliplatin-based therapy, 35% received bevacizumab plus irinotecan-based therapy, and 15% received bevacizumab plus monotherapy.

Of these patients, 1,286 (67%) were aged <65 years, 499 (26%) were aged 65 to 74 years, and 129 (7%) were aged >=75 years.

Overall, similar median progression-free survival (PFS) was seen across all subgroups. Because few patients were in the oldest group, formal comparison was made between patients in the 2 younger age groups. The hazard ratio for age >=65 versus <65 years was 1.18 (95% confidence interval [CI], 1.04-1.33; P < .05).

The incidence of bevacizumab-related toxicities such as gastrointestinal perforation, postoperative bleeding, wound-healing complications, and hypertension was similar in all groups. A higher rate of thromboembolic events and proteinuria was seen in patients aged >=75 years. The researchers said the thromboembolic events may have been related to pre-existing disease.

They concluded that bevacizumab plus chemotherapy is safe and effective treatment for older patients with metastatic colorectal cancer and that this patient population can derive similar clinical benefits to younger patients with similar toxicity.

Funding for this study was provided by F. Hoffman-LaRoche Ltd.

[Presentation title: Safety and Efficacy of Bevacizumab (BEV) and Chemotherapy in Elderly Patients With Metastatic Colorectal Cancer (MCRC): Results From the BEAT Observational Cohort Study. Abstract 5]