title: Survival outcomes of bevacizumab in first-line metastatic colorectal cancer in a real-life setting: results of the ETNA cohort.
abstract: Although the real-life benefits of bevacizumab may differ from clinical trials, observational data are rare. In this cohort study, the effectiveness of bevacizumab in first-line treatment of metastatic colorectal cancer was investigated. Patients initiating bevacizumab between January 2006 and December 2007 were identified in 28 French centres. Outcomes were investigated in the whole cohort and in those with irinotecan-based treatment that was used in the pivotal clinical trial; patients were stratified using inclusion/exclusion criteria of the pivotal clinical trial (PCT) (eligible for the PCT, not eligible or unclassifiable). The Kaplan-Meier method estimated progression-free survival (PFS) and overall survival (OS). A total of 411 patients were included: 57 % male, median age 65.1 years, 78 % Eastern Cooperative Oncology Group performance status ≤1, 88 % irinotecan-based regimen, median duration of bevacizumab use 5.5 months, median OS = 25.3 months (95 % confidence interval, CI [23.3; 27.0]) and median PFS = 10.1 months (95 % CI [9.5; 11.0]). Among the 360 patients who received irinotecan-based chemotherapy, 144 would have been eligible for the PCT, 194 not eligible and 22 unclassifiable. Median OS in those considered eligible was 29.1 (95 % CI [25.4; 33.6]) and in those considered not eligible this was 24.9 months (95 % CI [21.3; 26.9]); median PFS was respectively 11.5 months (95 % CI [10.3; 12.0]) and 9.4 months (95 % CI [8.8; 10.3]). The effectiveness of bevacizumab was found to be similar to that found in other studies including clinical trials which is reassuring.
authors.affiliation: Univ. Bordeaux, 33000, Bordeaux, France.
authors.forename: Annie
authors.initials: A
authors.lastname: Fourrier-Réglat
authors.forename: Denis
authors.initials: D
authors.lastname: Smith
authors.forename: Magali
authors.initials: M
authors.lastname: Rouyer
authors.forename: Jacques
authors.initials: J
authors.lastname: Bénichou
authors.forename: Rosine
authors.initials: R
authors.lastname: Guimbaud
authors.forename: Yves
authors.initials: Y
authors.lastname: Bécouarn
authors.forename: Olivier
authors.initials: O
authors.lastname: Bernard
authors.forename: Pernelle
authors.initials: P
authors.lastname: Noize
authors.forename: Nicholas
authors.initials: N
authors.lastname: Moore
authors.forename: Alain
authors.initials: A
authors.lastname: Ravaud
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000068258:Bevacizumab; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D005602:France; D006801:Humans; D000077146:Irinotecan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy; D009362:Neoplasm Metastasis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068258:Bevacizumab; D000077146:Irinotecan; D002166:Camptothecin