title: Effectiveness and safety of first-line bevacizumab plus FOLFIRI in elderly patients with metastatic colorectal cancer: Results of the ETNA observational cohort.
abstract: Effectiveness of bevacizumab for metastatic colorectal cancer in elderly patients has been investigated in observational studies, mainly associated with oxaliplatin-based regimens. Here, using the ETNA cohort in which the majority of patients received bevacizumab+FOLFIRI, the effectiveness of this combination in elderly patients is explored.
  
  
  
  Patients initiating first-line therapy with bevacizumab between January 2006 and December 2007 were identified in 28 French centres and followed for 24months. Vital status was collected over 36months. In the present analysis those who received FOLFIRI were retained (85% of those included), and patients were stratified by age (<70/≥70years). The Kaplan-Meier method estimated progression-free survival (PFS) and overall survival (OS), and Cox models were used to assess the independent effect of age on survival outcomes.
  
  
  
  Among the 351 patients who received bevacizumab+FOLFIRI, 33.9% were aged ≥70years, 66.1% <70years. Respectively 15.1% and 9.5% of patients had ECOG-PS ≥2; 49.6% and 40.1% used 'stop-and-go' treatment scheduling; and 56.3% and 44.4% experienced grade 3/4 adverse events. Overall response rate was 58.8% and 62.5%. Median [95% confidence interval, CI] OS was respectively 24.1 [20.4; 26.2] and 28.5 [25.0; 31.0] months; age≥70years and ECOG-PS≥2 were significantly associated with death. Median PFS [95% CI] was respectively 10.9 [9.4; 12.6] and 9.8 [9.2; 11.2] months; hepatic metastases was associated with progression, and age ≥70years was associated with progression after 14months of follow-up but not before.
  
  
  
  The present study adds to the literature on the safe and beneficial effect of bevacizumab in the elderly receiving FOLFIRI regimen.
authors.affiliation: Univ. Bordeaux, F-33000, Bordeaux, France; CIC Bordeaux CIC1401, F-33000, Bordeaux, France; ADERA, F-33600, Pessac, France.
authors.forename: Magali
authors.initials: M
authors.lastname: Rouyer
authors.affiliation: Univ. Bordeaux, F-33000, Bordeaux, France; CIC Bordeaux CIC1401, F-33000, Bordeaux, France; CHU Bordeaux, F-33000, Bordeaux, France; INSERM U1219, F-33000, Bordeaux, France. Electronic address: annie.fourrier-reglat@u-bordeaux.fr.
authors.forename: Annie
authors.initials: A
authors.lastname: Fourrier-Réglat
authors.affiliation: CHU Bordeaux, F-33000, Bordeaux, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Smith
authors.affiliation: Institut Bergonié, F-33076, Bordeaux, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Becouarn
authors.affiliation: CHU Toulouse, F-31059, Toulouse, France.
authors.forename: Rosine
authors.initials: R
authors.lastname: Guimbaud
authors.affiliation: CHU Limoges, F-87042, Limoges, France.
authors.forename: Nicole
authors.initials: N
authors.lastname: Tubiana-Mathieu
authors.affiliation: Univ. Bordeaux, F-33000, Bordeaux, France; CIC Bordeaux CIC1401, F-33000, Bordeaux, France; ADERA, F-33600, Pessac, France.
authors.forename: Philip
authors.initials: P
authors.lastname: Robinson
authors.affiliation: Univ. Bordeaux, F-33000, Bordeaux, France; CIC Bordeaux CIC1401, F-33000, Bordeaux, France; ADERA, F-33600, Pessac, France.
authors.forename: Jérémy
authors.initials: J
authors.lastname: Jové
authors.affiliation: Univ. Bordeaux, F-33000, Bordeaux, France; CIC Bordeaux CIC1401, F-33000, Bordeaux, France; ADERA, F-33600, Pessac, France.
authors.forename: Angela
authors.initials: A
authors.lastname: Grelaud
authors.affiliation: CIC Bordeaux CIC1401, F-33000, Bordeaux, France; CHU Bordeaux, F-33000, Bordeaux, France; INSERM U1219, F-33000, Bordeaux, France.
authors.forename: Pernelle
authors.initials: P
authors.lastname: Noize
authors.affiliation: Univ. Bordeaux, F-33000, Bordeaux, France; CIC Bordeaux CIC1401, F-33000, Bordeaux, France; CHU Bordeaux, F-33000, Bordeaux, France; INSERM U1219, F-33000, Bordeaux, France.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Moore
authors.affiliation: Univ. Bordeaux, F-33000, Bordeaux, France; CIC Bordeaux CIC1401, F-33000, Bordeaux, France; CHU Bordeaux, F-33000, Bordeaux, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Ravaud
mesh_terms: D000368:Aged; D000074322:Antineoplastic Agents, Immunological / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000008:administration & dosage; D002166:Camptothecin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D016016:Proportional Hazards Models; D015996:Survival Rate
chemical_list: D000074322:Antineoplastic Agents, Immunological; D000068258:Bevacizumab; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin
keywords: Aged; Bevacizumab; Cohort studies; Colorectal neoplasms; Molecular targeted therapy; Secondary