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Survival outcomes of bevacizumab in first-line metastatic colorectal cancer in a real-life setting: results of the ETNA cohort

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Abstract

Although the real-life benefits of bevacizumab may differ from clinical trials, observational data are rare. In this cohort study, the effectiveness of bevacizumab in first-line treatment of metastatic colorectal cancer was investigated. Patients initiating bevacizumab between January 2006 and December 2007 were identified in 28 French centres. Outcomes were investigated in the whole cohort and in those with irinotecan-based treatment that was used in the pivotal clinical trial; patients were stratified using inclusion/exclusion criteria of the pivotal clinical trial (PCT) (eligible for the PCT, not eligible or unclassifiable). The Kaplan–Meier method estimated progression-free survival (PFS) and overall survival (OS). A total of 411 patients were included: 57 % male, median age 65.1 years, 78 % Eastern Cooperative Oncology Group performance status ≤1, 88 % irinotecan-based regimen, median duration of bevacizumab use 5.5 months, median OS = 25.3 months (95 % confidence interval, CI [23.3; 27.0]) and median PFS = 10.1 months (95 % CI [9.5; 11.0]). Among the 360 patients who received irinotecan-based chemotherapy, 144 would have been eligible for the PCT, 194 not eligible and 22 unclassifiable. Median OS in those considered eligible was 29.1 (95 % CI [25.4; 33.6]) and in those considered not eligible this was 24.9 months (95 % CI [21.3; 26.9]); median PFS was respectively 11.5 months (95 % CI [10.3; 12.0]) and 9.4 months (95 % CI [8.8; 10.3]). The effectiveness of bevacizumab was found to be similar to that found in other studies including clinical trials which is reassuring.

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Acknowledgments

The authors wish to thank Dr Philip Robinson for his help in writing this paper and who is an employee of the Service de Pharmacologie, Université de Bordeaux. The ETNA study group included D. Smith—CHU Bordeaux, N. Tubiana-Mathieu—CHU Limoges, P. Michel—CHU Rouen, R. Guimbaud—CHU Toulouse, Y. Becouarn—Institut Bergonié Bordeaux, F. Viret—Institut Paoli-Calmettes Marseille, R. Guimbaud—Institut Claudius Regaud Toulouse, D. Larregain-Fournier—CH Bayonne, Y. Botreau—CH Cahors, P. Texereau—CH Mont de Marsan, D. Auby—CH Libourne, L. Gautier-Felizot—CH Dax, I. Loury-Larivière—CH Pau, E. Brudieux—CH Villeneuve sur Lot, L. Cany—Polyclinique Francheville Périgueux, C. Lecaille—Polyclinique Bordeaux Nord, D. Jaubert—Clinique Tivoli Bordeaux, P. Guichard—Polyclinique Bordeaux Rive Droite, O. Bernard—Clinique Calabet Agen, L. Vives—CH Saint Gaudens, N. Taoubi—CH Villefranche de Rouergue, M. Martinez—Clinique du Parc Toulouse, F. Burki—Clinique de l’Union Toulouse, I. Roque—Clinique des Cèdres Cornebarrieu, F. Thouveny—Clinique du Pont de Chaume Montauban and MH. Gaspard—Clinique Claude Bernard Albi.

This work was supported by partial funding from the French National Clinical Research Programme (Programme Hospitalier de Recherche Clinique) from the French Ministry of Health [grant number 2005/PHRC/INCa/DHOS], and an additional unconditional grant from Roche SAS, manufacturers of bevacizumab, who had no role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the report for publication.

Conflict of interest

JB had no support from any organisation for the submitted work. AFR, DS, MR, YB, OB, PN, NM and AR had support from the French National Clinical Research Program and Roche SAS, manufacturers of bevacizumab, for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years. RG had support from Roche SAS, manufacturers of bevacizumab, for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years.

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Authors and Affiliations

  1. Univ. Bordeaux, 33000, Bordeaux, France

    Annie Fourrier-Réglat, Magali Rouyer, Pernelle Noize, Nicholas Moore & Alain Ravaud

  2. INSERM, U657, 33000, Bordeaux, France

    Annie Fourrier-Réglat, Jacques Bénichou, Pernelle Noize & Nicholas Moore

  3. CHU de Bordeaux, 33000, Bordeaux, France

    Annie Fourrier-Réglat, Denis Smith, Pernelle Noize, Nicholas Moore & Alain Ravaud

  4. INSERM CIC-P0005, 33000, Bordeaux, France

    Annie Fourrier-Réglat, Denis Smith, Magali Rouyer, Pernelle Noize, Nicholas Moore & Alain Ravaud

  5. CHU de Rouen, 76031, Rouen, France

    Jacques Bénichou

  6. CHU de Toulouse, 31059, Toulouse, France

    Rosine Guimbaud

  7. Institut Bergonié, 33076, Bordeaux, France

    Yves Bécouarn

  8. Centre de Radiothérapie et d’Oncologie de Moyenne Garonne, 47000, Agen, France

    Olivier Bernard

  9. Service d’Oncologie Médicale, INSERM CIC-P 0005, CHU de Bordeaux, 33075, Bordeaux, France

    Alain Ravaud

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  1. Annie Fourrier-Réglat
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on behalf of the ETNA study group.

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Correspondence to Alain Ravaud.

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Fourrier-Réglat, A., Smith, D., Rouyer, M. et al. Survival outcomes of bevacizumab in first-line metastatic colorectal cancer in a real-life setting: results of the ETNA cohort. Targ Oncol 9, 311–319 (2014). https://doi.org/10.1007/s11523-013-0296-3

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  • DOI: https://doi.org/10.1007/s11523-013-0296-3

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