P-0232 - Extending targeted therapy beyond first-line (1L) chemotherapy backbone: real-world treatment patterns and outcomes in patients with metastatic colo...

Date 28 June 2014
Event World GI 2014
Session Poster Session
Topics Anti-Cancer Agents & Biologic Therapy
Colon Cancer
Rectal Cancer
Presenter Sham Chaudhari
Citation Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165
Authors S. Chaudhari1, T. McLaughlin1, M. Shah1, A. Cameron2
  • 1Xcenda, Palm Harbor/US
  • 2Genentech, South San Francisco/US



Previous analyses have assessed the impact of extending targeted therapy beyond the completion of chemotherapy backbone for patients with mCRC. This real-world retrospective chart review assessed the impact of continued bevacizumab (BEV) treatment on survival outcomes after completion of 1L FOLFOX/FOLFIRI in patients with mCRC.


Patients with a diagnosis of mCRC who received 1L treatment with FOLFOX/FOLFIRI + BEV at one of 15 community-based oncology clinics were eligible. Patients who received a liver resection at any time during the study period were excluded. Treatment landmarks of 6 (primary analysis) and 4 (sensitivity analysis) months were established and all patients included in the treatment groups were progression-free until the landmark. Patients treated with BEV following chemotherapy backbone completion and beyond the landmark were included in the “maintenance” group, while those who discontinued BEV treatment and chemotherapy backbone concurrently (or prior to the landmark) were included in the “non-maintenance” group. We assessed progression free survival (PFS), overall survival (OS), treatment patterns, and patient demographics.


From 2006 to 2012, 220 patients met the study criteria (maintenance group, N = 54; non-maintenance group, N = 166). With the exception of mean BMI at index and primary tumor location, patient demographics were similar across treatment groups. The mean length of therapy with BEV for patients in the maintenance group was 312 days as compared to 164 days for patients in the non-maintenance group (p < 0.0001). In adjusted analyses using the 6 month treatment landmark, the median PFS in the maintenance group was 46.5 weeks versus 40 weeks for the non-maintenance group (HR:0.53, 95% CI [0.36-0.76], p = 0.0007). The median OS in the maintenance group was 124 weeks versus 120 weeks for the non-maintenance group (HR: 0.72, 95% CI [0.47-1.11], p = not significant). Similar results were seen when using the 4 month treatment landmark (PFS: HR: 0.59, 95% CI [0.43-0.81], p = 0.0011; OS: HR:1.03, 95% CI [0.71-1.49], p = not significant).


Patients treated in a community setting who continued BEV following 1L FOLFOX/FOLFIRI had longer PFS than patients who stopped BEV concurrently with 1L FOLFOX/FOLFIRI. Results suggest that clinicians should consider continuing BEV even after completion of 1L chemotherapy backbone in mCRC patients.