Early dissemination of bevacizumab for advanced colorectal cancer: a prospective cohort study.
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 < 55 years (adjusted OR 0.13; 95% CI 0.04-0.46; p = 0.001). 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.
Zafar, SY; Malin, JL; Grambow, SC; Abbott, DH; Schrag, D; Kolimaga, JT; Zullig, LL; Weeks, JC; Fouad, MN; Ayanian, JZ; Wallace, R; Kahn, KL; Ganz, PA; Catalano, P; West, DW; Provenzale, D; Cancer Care and Outcomes Research and Surveillance (CanCORS) Consortium,
Volume / Issue
Start / End Page
Pubmed Central ID
Electronic International Standard Serial Number (EISSN)
Digital Object Identifier (DOI)