BMC Cancer (Aug 2011)

Early dissemination of bevacizumab for advanced colorectal cancer: a prospective cohort study

  • Fouad Mona N,
  • Weeks Jane C,
  • Zullig Leah L,
  • Kolimaga Jane T,
  • Schrag Deborah,
  • Abbott David H,
  • Grambow Steven C,
  • Malin Jennifer L,
  • Zafar S Yousuf,
  • Ayanian John Z,
  • Wallace Robert,
  • Kahn Katherine L,
  • Ganz Patricia A,
  • Catalano Paul,
  • West Dee W,
  • Provenzale Dawn

DOI
https://doi.org/10.1186/1471-2407-11-354
Journal volume & issue
Vol. 11, no. 1
p. 354

Abstract

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Abstract Background We describe early dissemination patterns for first-line bevacizumab given for metastatic colorectal cancer treatment. Methods We analyzed patient surveys and medical records for a population-based cohort with metastatic colorectal cancer treated in multiple regions and health systems in the United States (US). Eligible patients were diagnosed with metastatic colorectal cancer and initiated first-line chemotherapy after US Food & Drug Administration (FDA) bevacizumab approval in February 2004. First-line bevacizumab therapy was defined as receiving bevacizumab within 8 weeks of starting chemotherapy for metastatic colorectal cancer. We evaluated factors associated with first-line bevacizumab treatment using logistic regression. Results Among 355 patients, 31% received first-line bevacizumab in the two years after FDA approval, including 26% of men, 41% of women, and 16% of those ≥ 75 years. Use rose sharply within 6 months after FDA approval, then plateaued. 20% of patients received bevacizumab in combination with irinotecan; 53% received it with oxaliplatin. Men were less likely than women to receive bevacizumab (adjusted OR 0.55; 95% CI 0.32-0.93; p = 0.026). Patients ≥ 75 years were less likely to receive bevacizumab than patients Conclusions One-third of eligible metastatic colorectal cancer patients received first-line bevacizumab shortly after FDA approval. Most patients did not receive bevacizumab as part of the regimen used in the pivotal study leading to FDA approval.