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Poster display session

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


09 Sep 2017


Poster display session


Timothy Price


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


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


Abstract 2889


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


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).


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).


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


Legal entity responsible for the study

Adelaide Colorectal Tumor Group




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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