Effect of bevacizumab in older patients with metastatic colorectal cancer: pooled analysis of four randomized studies.

Journal Article (Journal Article)

BACKGROUND: Bevacizumab is frequently combined with 5-fluorouracil-based chemotherapy for patients with metastatic colorectal cancer (mCRC). The relative benefit of bevacizumab in older patients has not been widely studied and is of interest. PATIENTS AND METHODS: This retrospective analysis used data from three first-line randomized controlled studies and one second-line randomized controlled study of bevacizumab plus chemotherapy in medically fit (Eastern Cooperative Oncology Group performance status 0 or 1) patients with mCRC. Overall survival (OS) and on-treatment progression-free survival (PFS) were assessed in patients aged <65, > or =65, and > or =70 years. Results were compared using unstratified hazard ratios (HRs). Grade 3-5 adverse events were also assessed. RESULTS: Bevacizumab statistically significantly improved PFS [HR 0.58; 95% confidence interval (CI) 0.49-0.68] and OS (HR 0.85; 95% CI 0.74-0.97) in patients aged > or =65 years; patients aged > or =70 years had similar improvements. Benefits were consistent across the studies, irrespective of setting, bevacizumab dose, or chemotherapy regimen. Increases in thromboembolic events were observed in patients aged > or =65 and > or =70 years in the bevacizumab group compared with the control group, mainly as a result of increases in arterial thromboembolic events. No other substantial age-related increases in grade 3-5 adverse events were observed. CONCLUSIONS: In medically fit older patients, bevacizumab provides similar PFS and OS benefits as in younger patients.

Full Text

Duke Authors

Cited Authors

  • Cassidy, J; Saltz, LB; Giantonio, BJ; Kabbinavar, FF; Hurwitz, HI; Rohr, U-P

Published Date

  • May 2010

Published In

Volume / Issue

  • 136 / 5

Start / End Page

  • 737 - 743

PubMed ID

  • 19904559

Pubmed Central ID

  • PMC2841755

Electronic International Standard Serial Number (EISSN)

  • 1432-1335

Digital Object Identifier (DOI)

  • 10.1007/s00432-009-0712-3


  • eng

Conference Location

  • Germany