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Poster display session

2889 - Bevacizumab first line and impact on subsequent anti-EGFR activity.

Date

09 Sep 2017

Session

Poster display session

Presenters

Timothy Price

Citation

Annals of Oncology (2017) 28 (suppl_5): v158-v208. 10.1093/annonc/mdx393

Authors

T.J. Price1, J. Hardingham1, C. Karapetis2, E. Smith3, R. Padbury4, A. Roy2, D. Roder5, M.E. Burge6, A. Townsend3

Author affiliations

  • 1 Medical Oncology, Queen Elizabeth Hospital and University of Adelaide, 5011 - Woodville/AU
  • 2 Medical Oncology, Flinders Centre for Innovation in Cancer, 5042 - Bedford Park/AU
  • 3 Medical Oncology, Queen Elizabeth Hospital and University of Adelaide, 5011 - Adelaide/AU
  • 4 Surgery, Flinders University, Adelaide/AU
  • 5 Epidemiology, University of South Australia, Adelaide/AU
  • 6 Medical Oncology, Royal Brisbane and Women's Hospital, Brisbane/AU
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Resources

Abstract 2889

Background

Authors hypothesize that initial anti-VEGF therapy may induce biological changes that then increase the risk of acquired resistance to subsequent EGFR inhibitors.

Methods

A retrospective cohort study was performed to compare the characteristics and survival of patients who were treated with an anti-EGFR therapy at 2nd line and beyond. We separated two groups defined by the first line therapy; 1. chemotherapy plus bevacizumab (CB) and 2. chemo (C) alone. Two survival times were measured for this in this updated analysis; survival from the time of commencing first line chemotherapy and survival from commencement of anti-EGFR therapy. We analysed outcomes separately for the 2nd line anti-EGFR groups (2L) and the ‘3rd line and beyond’ (3L) groups, Long rank (mantel-cox) test analysis was performed to determine whether receiving first line bev was associated with worse overall survival (OS).

Results

450 mCRC patients who received either CB (n = 249) or C (n = 201), and then an anti-EGFR therapy were studied. Significant differences between CB and C groups for patient characteristics included; decreased median age (61.3 years (range 20.6 - 86.7) v 64.5 (24.3 - 91.8), p = 0.0006), lower use of irinotecan regimens (22% v 42%) and increased use of single agent FU (11% v 1.5%). There was no difference in gender (males 65.5% v 66.7%). There was no difference in proportion of patients receiving anti-EGFR second line (2L), CB 39% v C 43%. Where BRAF MT status was assessed 11% had MT (CB 23% v C 0). Median OS for the 2L group, as measured from the commencement of first line therapy, was 24.4 months for CB v 18.9 months for C (p = 0.0176). Median OS for the 3L group from the commencement of first line therapy was 32.8 months for CB v 29.9 months for C (p = NS). The survival from commencement of anti-EGFR therapy for CB v C respectively was; 2L 10.5 months v 11.6 months (p=NS), 3L 9.9 months v 8.3 months (p=NS).

Conclusions

Overall survival was significantly improved for CB compared to C when measured from initial treatment. This likely reflects patient selection. Overall survival however from commencement of 2L or 3L anti-EGFR was not altered significantly by prior exposure to bevacizumab in this population based registry.

Clinical trial identification

NA

Legal entity responsible for the study

Adelaide Colorectal Tumor Group

Funding

None

Disclosure

T.J. Price: Advisory board member of Roche, Merck, Amgen. Travel support: Amgen. All other authors have declared no conflicts of interest.

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