title: Efficacy and safety of bevacizumab in elderly patients with metastatic colorectal cancer: results from the Czech population-based registry.
abstract: BACKGROUND
  Patients aged 65 years and older represent the majority of patients with metastatic colorectal cancer (mCRC). However, this patient population is often underrepresented in clinical trials and probably undertreated in the clinical practice.
  
  
  METHODS
  We have analysed the outcomes of 3,187 mCRC patients treated with first-line bevacizumab based on data from the Czech national registry of mCRC patients aiming to compare the treatment efficacy and safety according to the age categories.
  
  
  RESULTS
  In total, 2,126 (66.7%), 932 (29.2%), and 129 (4.0%) patients were aged <65 years, 65 to 75 years, and 75+ years, respectively. Median progression-free survival (PFS) was 11.4, 11.3, and 11.8 months for patients aged <65 years, 65 to 75 years, and 75+ years, respectively (p = 0.94). Median overall survival (OS) was 26.9, 27.5, and 25.1 months for patients aged <65 years, 65 to 75 years, and 75+ years, respectively (p = 0.73). Using multivariable Cox model for both PFS and OS, the patient age was not significantly associated with either PFS or OS. No increase in bevacizumab-related toxicity was observed among the elderly mCRC patients with the exception of hypertension, which was observed in 71 (3.3%), 34 (3.6%), and 10 (7.8%) patients aged <65 years, 65 to 75 years, and 75+ years, respectively.
  
  
  CONCLUSIONS
  The results of the present study suggest similar outcome in terms of OS and PFS with bevacizumab-containing therapy in elderly mCRC patients fit for chemotherapy combined with targeted therapy compared to younger patients. Thus, chronological age should not be considered to represent a limitation in prescribing bevacizumab-containing therapy in mCRC patients.
authors.forename: Lubomir
authors.initials: L
authors.lastname: Slavicek
authors.forename: Tomas
authors.initials: T
authors.lastname: Pavlik
authors.forename: Jiri
authors.initials: J
authors.lastname: Tomasek
authors.forename: Zbynek
authors.initials: Z
authors.lastname: Bortlicek
authors.forename: Tomas
authors.initials: T
authors.lastname: Buchler
authors.forename: Bohuslav
authors.initials: B
authors.lastname: Melichar
authors.forename: Rostislav
authors.initials: R
authors.lastname: Vyzula
authors.forename: Jana
authors.initials: J
authors.lastname: Prausova
authors.forename: Jindrich
authors.initials: J
authors.lastname: Finek
authors.forename: Ondrej
authors.initials: O
authors.lastname: Majek
authors.affiliation: Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic. dusek@iba.muni.cz.
authors.forename: Ladislav
authors.initials: L
authors.lastname: Dusek
mesh_terms: D000367:Age Factors; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000068258:Bevacizumab; D000069287:Capecitabine; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D018153:Czech Republic; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D053208:Kaplan-Meier Estimate; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D010071:Oxaloacetates; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D013923:Thromboembolism / Q000139:chemically induced
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D010071:Oxaloacetates; D003841:Deoxycytidine; D000068258:Bevacizumab; D000069287:Capecitabine; D002955:Leucovorin; D005472:Fluorouracil