title: Benefit of Bevacizumab-Based Frontline Therapy in Patients with Metastatic Colorectal Cancer (mCRC): a Turkish Oncology Group Study.
abstract: BACKGROUND
  Several chemotherapy regimens using bevacizumab have been developed. Our goal was to investigate regimens that have demonstrated significant clinical activity in patients with metastatic colorectal cancer (mCRC).
  
  
  METHODS
  Six hundred and sixty six patients with mCRC who received first-line chemotherapy combination with bevacizumab were studied. Fluoropyrimidine (F) plus irinotecan (I)-based (FI-bev), F plus oxaliplatin (O)-based (FO-bev), and F-based (F-bev) treatment regimens were compared with respect to progression-free survival (PFS) and overall survival (OS).
  
  
  RESULTS
  The median PFS of FI-bev (n = 414) was 10.9 months (95 % CI 10-11.8), of FO-bev (n = 211) was 9.4 months (95 % CI 8.3-10.4), and of F-bev (n = 41) was 9.5 months (95 % CI 5.9-13.1) (p = 0.089). The median OS of FI-bev was 26.3 months (95 % CI 21.7-30.9), of FO-bev was 27 months (95 % CI 24.3-29.7), and of F-bev was 23.3 months (95 % CI 12.7-33.9) (p = 0.102). In KRAS wild-type patients, the median PFS of FI-bev group was significantly longer than FO-bev group (10.5 vs. 9.1 months, p = 0.006). The FI-bev group had better OS than FO-bev group with borderline significance (p = 0.058). The FI-bev group had significantly longer OS than F-bev group. Patients who underwent metastasectomy or those with Eastern Cooperative Oncology Group performance status (ECOG-PS) ≤1 had longer PFS and OS independent of the type of chemotherapy regimen.
  
  
  CONCLUSIONS
  FI-bev may be the preferred frontline regimen for patients with KRAS wild-type mCRC. Metastasectomy and performance score were the strongest positive predictors of OS and PFS regardless of backbone chemotherapy regimen.
authors.affiliation: Department of Medical Oncology, Necmettin Erbakan University, Meram Medical Faculty, 42080, Konya, Turkey. mehmetartac@yahoo.com.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Artaç
authors.affiliation: Department of Medical Oncology, Akdeniz University Faculty of Medicine, Antalya, Turkey.
authors.forename: Hasan Şenol
authors.initials: HŞ
authors.lastname: Coşkun
authors.affiliation: Department of Medical Oncology, Marmara University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Faysal
authors.initials: F
authors.lastname: Dane
authors.affiliation: Department of Medical Oncology, Ege University Faculty of Medicine, Izmir, Turkey.
authors.forename: Bülent
authors.initials: B
authors.lastname: Karabulut
authors.affiliation: Department of Medical Oncology, Necmettin Erbakan University, Meram Medical Faculty, 42080, Konya, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Korkmaz
authors.affiliation: Department of Medical Oncology, Necmettin Erbakan University, Meram Medical Faculty, 42080, Konya, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Karaağaç
authors.affiliation: Department of Medical Oncology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
authors.forename: Devrim
authors.initials: D
authors.lastname: Çabuk
authors.affiliation: Department of Medical Oncology, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey.
authors.forename: Senem
authors.initials: S
authors.lastname: Karabulut
authors.affiliation: Department of Medical Oncology, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey.
authors.forename: Nuri
authors.initials: N
authors.lastname: Faruk Aykan
authors.affiliation: Department of Medical Oncology, Acıbadem Bursa Hospital, Bursa, Turkey.
authors.forename: Hatice
authors.initials: H
authors.lastname: Doruk
authors.affiliation: Department of Medical Oncology, Ali Osman Sönmez Oncology Hospital, Bursa, Turkey.
authors.forename: Nilüfer
authors.initials: N
authors.lastname: Avcı
authors.affiliation: Department of Medical Oncology, Anadolu Medical Center, Istanbul, Turkey.
authors.forename: Nazım Serdar
authors.initials: NS
authors.lastname: Turhal
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000008:administration & dosage; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D000077146:Irinotecan; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D012189:Retrospective Studies; D016896:Treatment Outcome; D014421:Turkey
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D000068258:Bevacizumab; D000077146:Irinotecan; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin
keywords: Fluoropyrimidine plus bevacizumab; Irinotecan plus bevacizumab; Metastatic colorectal cancer; Oxaliplatin plus bevacizumab