Evaluation of Second-Line Anti-VEGF after First-Line Anti-EGFR Based Therapy in RAS Wild-Type Metastatic Colorectal Cancer: The Multicenter "SLAVE" Study

: Background: The optimal anti-angiogenic strategy as second-line treatment in RAS wild-type metastatic colorectal cancer (mCRC) treated with anti-EGFR (Epidermal Growth Factor Receptor) based first-line treatment is still debated.; METHODS: This multicenter, real-world, retrospective study is aimed...

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Detalhes bibliográficos
Autores: Parisi, Alessandro, Cortellini, Alessio, Cannita, Katia, Venditti, Olga, Camarda, Floriana, Calegari, Maria Alessandra, Salvatore, Lisa, Tortora, Giampaolo, Rossini, Daniele, Germani, Marco Maria, Boccaccino, Alessandra, Dell'Aquila, Emanuela, Fulgenzi, Claudia, Santini, Daniele, Tursi, Michele De, Tinari, Nicola, Marino, Pietro Di, Lombardi, Pasquale, Keranen, Susana Rosello, Alvaro, Marisol Huerta, Zurlo, Ina Valeria, Corsi, Domenico Cristiano, Emiliani, Alessandra, Zanaletti, Nicoletta, Troiani, Teresa, Vitale, Pasquale, Giampieri, Riccardo, Merloni, Filippo, Occhipinti, Mario Alberto, Marchetti, Paolo, Roberto, Michela, Mazzuca, Federica, Ghidini, Michele, Indini, Alice, Garajova, Ingrid, Zoratto, Federica, Monache, Simona Delle, Porzio, Giampiero, Ficorella, Corrado
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Recursos:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p4516
Acesso em linha:https://incliva.portalinvestigacion.com/publicaciones/4516
Access Level:acceso abierto
Palavra-chave:RAS wild-type mCRC
anti-angiogenics
second-line treatment
Aflibercept
Bevacizumab
Panitumumab
Cetuximab
Descrição
Resumo:: Background: The optimal anti-angiogenic strategy as second-line treatment in RAS wild-type metastatic colorectal cancer (mCRC) treated with anti-EGFR (Epidermal Growth Factor Receptor) based first-line treatment is still debated.; METHODS: This multicenter, real-world, retrospective study is aimed at evaluating the effectiveness of second-line Bevacizumab- and Aflibercept-based treatments after an anti-EGFR based first-line regimen. Clinical outcomes measured were: objective response rate (ORR), progression free survival (PFS), overall survival (OS) and adverse events (AEs) profiles.; RESULTS: From February 2011 to October 2019, 277 consecutive mCRC patients received Bevacizumab-based (228, 82.3%) or Aflibercept-based (49, 17.7%) regimen. No significant difference was found regarding ORR. The median follow-up was 27.7 months (95%CI: 24.7-34.4). Aflibercept-treated group had a significantly shorter PFS compared to Bevacizumab-treated group (5.6 vs. 7.1 months, respectively) (HR = 1.34 (95%CI: 0.95-1.89); p = 0.0932). The median OS of the Bevacizumab-treated group and Aflibercept-treated group was 16.2 (95%CI: 15.3-18.1) and 12.7 (95%CI: 8.8-17.5) months, respectively (HR= 1.31 (95%CI: 0.89-1.93) p = 0.16). After adjusting for the key covariates (age, gender, performance status, number of metastatic sites and primary tumor side) Bevacizumab-based regimens revealed to be significantly related with a prolonged PFS (HR = 1.44 (95%CI: 1.02-2.03); p = 0.0399) compared to Aflibercept-based regimens, but not with a prolonged OS (HR = 1.47 (95%CI: 0.99-2.17); p = 0.0503). The incidence of G3/G4 VEGF inhibitors class-specific AEs was 7.5% and 26.5% in the Bevacizumab-treated group and the Aflibercept-treated group, respectively (p = 0.0001).; CONCLUSION: Our analysis seems to reveal that Bevacizumab-based regimens have a slightly better PFS and class-specific AEs profile compared to Aflibercept-based regimen as second-line treatment of RAS wild-type mCRC patients previously treated with anti-EGFR based treatments. These results have to be taken with caution and no conclusive considerations are allowed.

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