Bevacizumab and aflibercept in second-line metastatic colorectal cancer: 12 years of experience

• Published in: European journal of clinical pharmacology 2022-02, Vol.78 (2), p.287-291
• Main Authors: Claramunt García, Raquel, Muñoz Cid, Carmen Lucía, Sánchez Ruiz, Andrés, Marín Pozo, Juan Francisco
• Format: Article
• Language: English
• Subjects: Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bevacizumab; Bevacizumab - administration & dosage; Bevacizumab - adverse effects; Bevacizumab - therapeutic use; Biomedical and Life Sciences; Biomedicine; Chemotherapy; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - drug therapy; Colorectal Neoplasms - pathology; Female; Fluorouracil - therapeutic use; Humans; Leucovorin - therapeutic use; Male; Metastases; Metastasis; Middle Aged; Monoclonal antibodies; Neoplasm Metastasis; Neutropenia; Organoplatinum Compounds - therapeutic use; Oxaliplatin; Patients; Pharmacoepidemiology and Prescription; Pharmacology/Toxicology; Progression-Free Survival; Receptors, Vascular Endothelial Growth Factor - administration & dosage; Receptors, Vascular Endothelial Growth Factor - therapeutic use; Recombinant Fusion Proteins - administration & dosage; Recombinant Fusion Proteins - adverse effects; Recombinant Fusion Proteins - therapeutic use; Retrospective Studies; Statistical analysis; Survival; Targeted cancer therapy; Thrombocytopenia; Toxicity
• ISSN: 0031-6970; 1432-1041
• DOI: 10.1007/s00228-021-03235-5

Purpose To evaluate and compare the efficacy and safety of bevacizumab and aflibercept in second-line treatment in metastatic colorectal cancer (mCRC) in real-life clinical practice. Methods Retrospective observational study of patients treated with second-line bevacizumab (BFIR) and aflibercept (AFIR) in mCRC, associated with a FOLFIRI scheme, in the last 12 years (January 2009–January 2021) in a tertiary hospital. Patients with prior oxaliplatin-based treatment were included. Variables measured: previous chemotherapy, treatment time (TT), progression-free survival (PFS), overall survival (OS). To assess toxicity, adverse effects that caused delay in cycle administration were recorded. The lost cycles/month of treatment (CP/MT) were also calculated. Results Eighty-four patients [40 (47.6%) AFIR and 44 (52.4%) BFIR]. Average age: 60.2 ± 10.7 years. In 79.8% the previous scheme was FOLFOX type. Efficacy of AFIR vs BFIR: median HR of TT (95% CI) = 0.816 (0.527–1.266); p  = 0.365, PFS HR (95% CI) = 0.674 (0.389–1.117); p  = 0.159, OS HR (95% CI) = 0.566 (0.342–0.936); p  = 0.026. The main reason for the delay in administration was neutropenia (28.7% AFIR vs 24.7% BFIR), and the greatest difference found was thrombopenia (13.9% AFIR vs 2.5% BFIR), without observing large differences between the rest of adverse reactions. Mean CP/MT: 0.49 ± 0.46 cycles with AFIR and 0.33 ± 0.27 with BFIR; p  = 0.046. Conclusion Although no statistically significant differences have been found in TT or PFS, it would be more advisable to use BFIR scheme due to its better results in OS and toxicity profile.