Тазовая хирургия и онкология (Mar 2022)

Efficacy and toxicity of aflibercept and bevacizumab in combination with FOLFIRI in second‑line therapy for metastatic colon cancer: a retrospective multicenter study

  • M.   Yu. Fedyanin,
  • L.  Yu.  Vladimirova,
  • V.  A.  Chubenko,
  • L.   A. Zagorskaya,
  • A.  V.  Belyaeva,
  • O.  L.  Fakhrutdinova,
  • S.  A.  Belukhin,
  • A.   S. Zhabina,
  • L.   V. Khalikova,
  • L.  V.  Bolotina,
  • R.   V. Orlova,
  • F.  V.  Moiseenko,
  • G.   Z. Mukhametshina,
  • A.  I.  Khasanova,
  • A.  V.  Belonogov,
  • Kh.  S.  Musaeva,
  • O.  Yu.  Novikova,
  • I.  Yu.  Stradaeva,
  • I.  L.  Popova,
  • S.  P.  Erdniev,
  • A.  K.  Ivanova,
  • A.  V.  Androsova,
  • P.  S.  Feoktistova,
  • E.  S.  Kuzmina,
  • E.   V. Karabina,
  • O.  V.  Nekrasova,
  • O.  V.  Sekhina,
  • A.   A. Mishchenko,
  • L.  A.  Mukova,
  • B.  Kh.  Kertiev,
  • G.  I.  Kosar,
  • S.   N. Osodoeva,
  • A.  I.  Kats,
  • R.  R.  Malina,
  • M.  A.  Lyadova,
  • A.  A.  Tryakin,
  • S.  A.  Tyulandin

DOI
https://doi.org/10.17650/2686-9594-2021-11-3-4-11-17
Journal volume & issue
Vol. 11, no. 3-4
pp. 11 – 17

Abstract

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Objective: to compare the efficacy and toxicity of aflibercept and bevacizumab in combination with fOLfIRI in secondline therapy for patients with metastatic colon cancer.Materials and methods. we performed a retrospective analysis of data on patients with metastatic colon cancer treated in 9 clinics in the Russian federation. The inclusion criteria were as follows: metastatic or locally advanced colon cancer; treatment with bevacizumab or aflibercept plus fOLfIRI in the second-line therapy. The primary outcome measure was progression-free survival (PfS). Secondary outcome measures included objective response rate and incidence of adverse events.Results. A total of 271 patients with metastatic colon cancer who received second-line therapy with bevacizumab (n = 81) or aflibercept (n = 190) between 2014 and 2018 were selected for this study. Study groups were matched for main prognostic signs. The objective response rate was 18.1 % in the bevacizumab group and 20.5 % in the aflibercept group (p = 0.7). The median PfS was 5 months (95 % confidence interval 3.8–6.1) in the aflibercept group and 7 months (95 % confidence interval 0.81–2.1) in the bevacizumab group (hazard ratio 1.4; 95 % confidence interval 0.99–2.1; p = 0.04). multivariate regression analysis demonstrated that the type of the targeted drug independently had no effect on PfS (hazard ratio 1.3; 95 % confidence interval 0.9–1.9; p = 0.2). we observed no statistically significant differences in the incidence of complications of any grades between the groups (58 % vs 72 %, p = 0.1). Patients receiving aflibercept were more likely to develop grade III–Iv arterial hypertension (2 % vs 9.5 %) and diarrhea (0 % vs 5.4 %), whereas thrombotic complications were more common in the bevacizumab group (10 % vs 1.8 %).Conclusion. we observed no significant differences in objective response rate and PfS between patients with metastatic colon cancer receiving bevacizumab or aflibercept in combination with fOLfIRI as second-line therapy. The toxicity profiles were different. Our findings can be used for choosing an optimal targeted drug for second-line treatment.

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