BMC Cancer (Oct 2021)

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

DOI
https://doi.org/10.1186/s12885-021-08890-6
Journal volume & issue
Vol. 21, no. 1
pp. 1 – 9

Abstract

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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.

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