title: Early dissemination of bevacizumab for advanced colorectal cancer: a prospective cohort study.
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 < 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.
authors.affiliation: Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, NC, USA. yousuf.zafar@duke.edu
authors.forename: S Yousuf
authors.initials: SY
authors.lastname: Zafar
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Malin
authors.forename: Steven C
authors.initials: SC
authors.lastname: Grambow
authors.forename: David H
authors.initials: DH
authors.lastname: Abbott
authors.forename: Deborah
authors.initials: D
authors.lastname: Schrag
authors.forename: Jane T
authors.initials: JT
authors.lastname: Kolimaga
authors.forename: Leah L
authors.initials: LL
authors.lastname: Zullig
authors.forename: Jane C
authors.initials: JC
authors.lastname: Weeks
authors.forename: Mona N
authors.initials: MN
authors.lastname: Fouad
authors.forename: John Z
authors.initials: JZ
authors.lastname: Ayanian
authors.forename: Robert
authors.initials: R
authors.lastname: Wallace
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Kahn
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Ganz
authors.forename: Paul
authors.initials: P
authors.lastname: Catalano
authors.forename: Dee W
authors.initials: DW
authors.lastname: West
authors.forename: Dawn
authors.initials: D
authors.lastname: Provenzale
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D015897:Comorbidity; D017277:Drug Approval; D005260:Female; D006801:Humans; D000077146:Irinotecan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D011446:Prospective Studies
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D000068258:Bevacizumab; D000077146:Irinotecan; D002166:Camptothecin