Second-line chemotherapy after early disease progression during first-line chemotherapy containing bevacizumab for patients with metastatic colorectal cancer
Shun Yamamoto,
Kengo Nagashima,
Takeshi Kawakami,
Seiichiro Mitani,
Masato Komoda,
Yasushi Tsuji,
Naoki Izawa,
Kentaro Kawakami,
Yoshiyuki Yamamoto,
Akitaka Makiyama,
Kentaro Yamazaki,
Toshiki Masuishi,
Taito Esaki,
Takako Eguchi Nakajima,
Hiroyuki Okuda,
Toshikazu Moriwaki,
Narikazu Boku
Affiliations
Shun Yamamoto
Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital
Kengo Nagashima
Research Center for Medical and Health Data Science, the Institute of Statistical Mathematics
Takeshi Kawakami
Division of Gastrointestinal Oncology, Shizuoka Cancer Center
Seiichiro Mitani
Department of Clinical Oncology, Aichi Cancer Center Hospital
Masato Komoda
Department of Gastrointestinal and Medical Oncology, National Hospital Organization Kyushu Cancer Center
Yasushi Tsuji
Department of Medical Oncology, Tonan Hospital
Naoki Izawa
Department of Clinical Oncology, St. Marianna University School of Medical Hospital
Kentaro Kawakami
Department of Medical Oncology, Keiyukai Sapporo Hospital
Yoshiyuki Yamamoto
Division of Gastroenterology, Faculty of Medicine, University of Tsukuba
Akitaka Makiyama
Department of Hematology/Oncology, Japan Community Healthcare Organization Kyushu Hospital
Kentaro Yamazaki
Division of Gastrointestinal Oncology, Shizuoka Cancer Center
Toshiki Masuishi
Department of Clinical Oncology, Aichi Cancer Center Hospital
Taito Esaki
Department of Gastrointestinal and Medical Oncology, National Hospital Organization Kyushu Cancer Center
Takako Eguchi Nakajima
Department of Clinical Oncology, St. Marianna University School of Medical Hospital
Hiroyuki Okuda
Department of Medical Oncology, Keiyukai Sapporo Hospital
Toshikazu Moriwaki
Division of Gastroenterology, Faculty of Medicine, University of Tsukuba
Narikazu Boku
Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital
Abstract Background The ML18174 study, which showed benefits of bevacizumab (BEV) continuation beyond progression (BBP) for metastatic colorectal cancer (mCRC), excluded patients with first-line progression-free survival (PFS) shorter than 3 months. The present study was conducted to evaluate the efficacy of second-line chemotherapy after early disease progression during first-line chemotherapy containing bevacizumab. Methods The subjects of this study were mCRC patients who experienced disease progression 2/unknown: 89/8/3 and 56/40/4%), RAS status (wild/mutant/unknown: 32/54/16 and 76/16/8%). Response rate was 8.6% in BBP group and 9.1% in non-BBP group (p = 1.00). Median PFS was 3.9 months in BBP group and 2.8 months in non-BBP group (HR [95%CI]: 0.79 [0.46–1.34], p = 0.373, adjusted HR: 0.87 [0.41–1.82], p = 0.707). Median overall survival was 8.5 months in BBP group and 5.4 months in non-BBP group (HR 0.66 [0.38–1.12], p = 0.125, adjusted HR 0.53 [0.27–1.07], p = 0.078). Conclusion In mCRC patients who experienced early progression in first-line chemotherapy, second-line chemotherapy showed poor clinical outcomes regardless use of anti-angiogenic agents.
