Evaluation of Second-Line Anti-VEGF after First-Line Anti-EGFR Based Therapy in RAS Wild-Type Metastatic Colorectal Cancer: The Multicenter “SLAVE” Study
Background: The optimal anti-angiogenic strategy as second-line treatment in <i>RAS</i> wild-type metastatic colorectal cancer (mCRC) treated with anti-EGFR (Epidermal Growth Factor Receptor) based first-line treatment is still debated. Methods: This multicenter, real-world, retrospectiv...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-05-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/12/5/1259 |
| _version_ | 1797567787522064384 |
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| author | Alessandro Parisi Alessio Cortellini Katia Cannita Olga Venditti Floriana Camarda Maria Alessandra Calegari Lisa Salvatore Giampaolo Tortora Daniele Rossini Marco Maria Germani Alessandra Boccaccino Emanuela Dell’Aquila Claudia Fulgenzi Daniele Santini Michele De Tursi Nicola Tinari Pietro Di Marino Pasquale Lombardi Susana Roselló Keränen Marisol Huerta Álvaro Ina Valeria Zurlo Domenico Cristiano Corsi Alessandra Emiliani Nicoletta Zanaletti Teresa Troiani Pasquale Vitale Riccardo Giampieri Filippo Merloni Mario Alberto Occhipinti Paolo Marchetti Michela Roberto Federica Mazzuca Michele Ghidini Alice Indini Ingrid Garajova Federica Zoratto Simona Delle Monache Giampiero Porzio Corrado Ficorella |
| author_facet | Alessandro Parisi Alessio Cortellini Katia Cannita Olga Venditti Floriana Camarda Maria Alessandra Calegari Lisa Salvatore Giampaolo Tortora Daniele Rossini Marco Maria Germani Alessandra Boccaccino Emanuela Dell’Aquila Claudia Fulgenzi Daniele Santini Michele De Tursi Nicola Tinari Pietro Di Marino Pasquale Lombardi Susana Roselló Keränen Marisol Huerta Álvaro Ina Valeria Zurlo Domenico Cristiano Corsi Alessandra Emiliani Nicoletta Zanaletti Teresa Troiani Pasquale Vitale Riccardo Giampieri Filippo Merloni Mario Alberto Occhipinti Paolo Marchetti Michela Roberto Federica Mazzuca Michele Ghidini Alice Indini Ingrid Garajova Federica Zoratto Simona Delle Monache Giampiero Porzio Corrado Ficorella |
| author_sort | Alessandro Parisi |
| collection | DOAJ |
| description | Background: The optimal anti-angiogenic strategy as second-line treatment in <i>RAS</i> wild-type metastatic colorectal cancer (mCRC) treated with anti-EGFR (Epidermal Growth Factor Receptor) based first-line treatment is still debated. Methods: This multicenter, real-world, retrospective study is aimed at evaluating the effectiveness of second-line Bevacizumab- and Aflibercept-based treatments after an anti-EGFR based first-line regimen. Clinical outcomes measured were: objective response rate (ORR), progression free survival (PFS), overall survival (OS) and adverse events (AEs) profiles. Results: From February 2011 to October 2019, 277 consecutive mCRC patients received Bevacizumab-based (228, 82.3%) or Aflibercept-based (49, 17.7%) regimen. No significant difference was found regarding ORR. The median follow-up was 27.7 months (95%CI: 24.7–34.4). Aflibercept-treated group had a significantly shorter PFS compared to Bevacizumab-treated group (5.6 vs. 7.1 months, respectively) (HR = 1.34 (95%CI: 0.95–1.89); <i>p</i> = 0.0932). The median OS of the Bevacizumab-treated group and Aflibercept-treated group was 16.2 (95%CI: 15.3–18.1) and 12.7 (95%CI: 8.8–17.5) months, respectively (HR= 1.31 (95%CI: 0.89–1.93) <i>p</i> = 0.16). After adjusting for the key covariates (age, gender, performance status, number of metastatic sites and primary tumor side) Bevacizumab-based regimens revealed to be significantly related with a prolonged PFS (HR = 1.44 (95%CI: 1.02–2.03); <i>p</i> = 0.0399) compared to Aflibercept-based regimens, but not with a prolonged OS (HR = 1.47 (95%CI: 0.99–2.17); <i>p</i> = 0.0503). The incidence of G3/G4 VEGF inhibitors class-specific AEs was 7.5% and 26.5% in the Bevacizumab-treated group and the Aflibercept-treated group, respectively (<i>p</i> = 0.0001). Conclusion: Our analysis seems to reveal that Bevacizumab-based regimens have a slightly better PFS and class-specific AEs profile compared to Aflibercept-based regimen as second-line treatment of <i>RAS</i> wild-type mCRC patients previously treated with anti-EGFR based treatments. These results have to be taken with caution and no conclusive considerations are allowed. |
| first_indexed | 2024-03-10T19:47:28Z |
| format | Article |
| id | doaj.art-3ba55e80521f44fea118625fbacfebb2 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T19:47:28Z |
| publishDate | 2020-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-3ba55e80521f44fea118625fbacfebb22023-11-20T00:41:13ZengMDPI AGCancers2072-66942020-05-01125125910.3390/cancers12051259Evaluation of Second-Line Anti-VEGF after First-Line Anti-EGFR Based Therapy in RAS Wild-Type Metastatic Colorectal Cancer: The Multicenter “SLAVE” StudyAlessandro Parisi0Alessio Cortellini1Katia Cannita2Olga Venditti3Floriana Camarda4Maria Alessandra Calegari5Lisa Salvatore6Giampaolo Tortora7Daniele Rossini8Marco Maria Germani9Alessandra Boccaccino10Emanuela Dell’Aquila11Claudia Fulgenzi12Daniele Santini13Michele De Tursi14Nicola Tinari15Pietro Di Marino16Pasquale Lombardi17Susana Roselló Keränen18Marisol Huerta Álvaro19Ina Valeria Zurlo20Domenico Cristiano Corsi21Alessandra Emiliani22Nicoletta Zanaletti23Teresa Troiani24Pasquale Vitale25Riccardo Giampieri26Filippo Merloni27Mario Alberto Occhipinti28Paolo Marchetti29Michela Roberto30Federica Mazzuca31Michele Ghidini32Alice Indini33Ingrid Garajova34Federica Zoratto35Simona Delle Monache36Giampiero Porzio37Corrado Ficorella38Medical Oncology, St. Salvatore Hospital, University of L’Aquila, 67100 L’Aquila, ItalyDepartment of Biotechnology and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, ItalyMedical Oncology, St. Salvatore Hospital, University of L’Aquila, 67100 L’Aquila, ItalyMedical Oncology, St. Salvatore Hospital, University of L’Aquila, 67100 L’Aquila, ItalyUniversità Cattolica del Sacro Cuore, 00168 Roma, ItalyUniversità Cattolica del Sacro Cuore, 00168 Roma, ItalyUniversità Cattolica del Sacro Cuore, 00168 Roma, ItalyUniversità Cattolica del Sacro Cuore, 00168 Roma, ItalyDepartment of Oncology, University Hospital of Pisa, 56100 Pisa, ItalyDepartment of Oncology, University Hospital of Pisa, 56100 Pisa, ItalyDepartment of Oncology, University Hospital of Pisa, 56100 Pisa, ItalyMedical Oncology, Campus Bio-Medico, University of Rome, 00128 Rome, ItalyMedical Oncology, Campus Bio-Medico, University of Rome, 00128 Rome, ItalyMedical Oncology, Campus Bio-Medico, University of Rome, 00128 Rome, ItalyDepartment of Medical, Oral and Biotechnological Sciences and Center for Advance Studies and Technology (CAST), G. D’Annunzio University, 66100 Chieti, ItalyDepartment of Medical, Oral and Biotechnological Sciences and Center for Advance Studies and Technology (CAST), G. D’Annunzio University, 66100 Chieti, ItalyClinical Oncology Unit, S.S. Annunziata Hospital, 66100 Chieti, ItalyDepartment of Oncology, University of Turin; Candiolo Cancer Institute-FPO-IRCCS, 10060 Candiolo, ItalyDepartment of Medical Oncology, INCLIVA Biomedical Research Institute, University of Valencia, 46010 Valencia, SpainDepartment of Medical Oncology, INCLIVA Biomedical Research Institute, University of Valencia, 46010 Valencia, SpainUniversità Cattolica del Sacro Cuore, 00168 Roma, ItalyUOC Oncologia Medica San Giovanni Calibita Fatebenefratelli Roma, 00186 Roma, ItalyUOC Oncologia Medica San Giovanni Calibita Fatebenefratelli Roma, 00186 Roma, ItalyDepartment of Precision Medicine, Università della Campania “Luigi Vanvitelli”, 80131 Napoli, ItalyDepartment of Precision Medicine, Università della Campania “Luigi Vanvitelli”, 80131 Napoli, ItalyDepartment of Precision Medicine, Università della Campania “Luigi Vanvitelli”, 80131 Napoli, ItalyClinica Oncologica e Centro Regionale di Genetica Oncologica, Università Politecnica delle Marche, AOU Ospedali Riuniti-Ancona, 60020 Ancona, ItalyClinica Oncologica e Centro Regionale di Genetica Oncologica, Università Politecnica delle Marche, AOU Ospedali Riuniti-Ancona, 60020 Ancona, ItalyMedical Oncology, Policlinico Umberto I, 00161 Rome, ItalyMedical Oncology, Policlinico Umberto I, 00161 Rome, ItalyDepartment of Clinical and Molecular Medicine, Oncology Unit, Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, ItalyDepartment of Clinical and Molecular Medicine, Oncology Unit, Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, ItalyMedical Oncology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milano, ItalyMedical Oncology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milano, ItalyMedical Oncology Unit, University Hospital of Parma, Via Gramsci 14, 43126 Parma, ItalyMedical Oncology, Santa Maria Goretti Hospital, 04100 Latina, ItalyDepartment of Biotechnological and Applied Clinical Sciences, Laboratory of Applied Biology, University of L’Aquila, 67100 L’Aquila, ItalyMedical Oncology, St. Salvatore Hospital, University of L’Aquila, 67100 L’Aquila, ItalyMedical Oncology, St. Salvatore Hospital, University of L’Aquila, 67100 L’Aquila, ItalyBackground: The optimal anti-angiogenic strategy as second-line treatment in <i>RAS</i> wild-type metastatic colorectal cancer (mCRC) treated with anti-EGFR (Epidermal Growth Factor Receptor) based first-line treatment is still debated. Methods: This multicenter, real-world, retrospective study is aimed at evaluating the effectiveness of second-line Bevacizumab- and Aflibercept-based treatments after an anti-EGFR based first-line regimen. Clinical outcomes measured were: objective response rate (ORR), progression free survival (PFS), overall survival (OS) and adverse events (AEs) profiles. Results: From February 2011 to October 2019, 277 consecutive mCRC patients received Bevacizumab-based (228, 82.3%) or Aflibercept-based (49, 17.7%) regimen. No significant difference was found regarding ORR. The median follow-up was 27.7 months (95%CI: 24.7–34.4). Aflibercept-treated group had a significantly shorter PFS compared to Bevacizumab-treated group (5.6 vs. 7.1 months, respectively) (HR = 1.34 (95%CI: 0.95–1.89); <i>p</i> = 0.0932). The median OS of the Bevacizumab-treated group and Aflibercept-treated group was 16.2 (95%CI: 15.3–18.1) and 12.7 (95%CI: 8.8–17.5) months, respectively (HR= 1.31 (95%CI: 0.89–1.93) <i>p</i> = 0.16). After adjusting for the key covariates (age, gender, performance status, number of metastatic sites and primary tumor side) Bevacizumab-based regimens revealed to be significantly related with a prolonged PFS (HR = 1.44 (95%CI: 1.02–2.03); <i>p</i> = 0.0399) compared to Aflibercept-based regimens, but not with a prolonged OS (HR = 1.47 (95%CI: 0.99–2.17); <i>p</i> = 0.0503). The incidence of G3/G4 VEGF inhibitors class-specific AEs was 7.5% and 26.5% in the Bevacizumab-treated group and the Aflibercept-treated group, respectively (<i>p</i> = 0.0001). Conclusion: Our analysis seems to reveal that Bevacizumab-based regimens have a slightly better PFS and class-specific AEs profile compared to Aflibercept-based regimen as second-line treatment of <i>RAS</i> wild-type mCRC patients previously treated with anti-EGFR based treatments. These results have to be taken with caution and no conclusive considerations are allowed.https://www.mdpi.com/2072-6694/12/5/1259<i>RAS</i> wild-type mCRCanti-angiogenicssecond-line treatmentAfliberceptBevacizumabPanitumumab |
| spellingShingle | Alessandro Parisi Alessio Cortellini Katia Cannita Olga Venditti Floriana Camarda Maria Alessandra Calegari Lisa Salvatore Giampaolo Tortora Daniele Rossini Marco Maria Germani Alessandra Boccaccino Emanuela Dell’Aquila Claudia Fulgenzi Daniele Santini Michele De Tursi Nicola Tinari Pietro Di Marino Pasquale Lombardi Susana Roselló Keränen Marisol Huerta Álvaro Ina Valeria Zurlo Domenico Cristiano Corsi Alessandra Emiliani Nicoletta Zanaletti Teresa Troiani Pasquale Vitale Riccardo Giampieri Filippo Merloni Mario Alberto Occhipinti Paolo Marchetti Michela Roberto Federica Mazzuca Michele Ghidini Alice Indini Ingrid Garajova Federica Zoratto Simona Delle Monache Giampiero Porzio Corrado Ficorella Evaluation of Second-Line Anti-VEGF after First-Line Anti-EGFR Based Therapy in RAS Wild-Type Metastatic Colorectal Cancer: The Multicenter “SLAVE” Study Cancers <i>RAS</i> wild-type mCRC anti-angiogenics second-line treatment Aflibercept Bevacizumab Panitumumab |
| title | Evaluation of Second-Line Anti-VEGF after First-Line Anti-EGFR Based Therapy in RAS Wild-Type Metastatic Colorectal Cancer: The Multicenter “SLAVE” Study |
| title_full | Evaluation of Second-Line Anti-VEGF after First-Line Anti-EGFR Based Therapy in RAS Wild-Type Metastatic Colorectal Cancer: The Multicenter “SLAVE” Study |
| title_fullStr | Evaluation of Second-Line Anti-VEGF after First-Line Anti-EGFR Based Therapy in RAS Wild-Type Metastatic Colorectal Cancer: The Multicenter “SLAVE” Study |
| title_full_unstemmed | Evaluation of Second-Line Anti-VEGF after First-Line Anti-EGFR Based Therapy in RAS Wild-Type Metastatic Colorectal Cancer: The Multicenter “SLAVE” Study |
| title_short | Evaluation of Second-Line Anti-VEGF after First-Line Anti-EGFR Based Therapy in RAS Wild-Type Metastatic Colorectal Cancer: The Multicenter “SLAVE” Study |
| title_sort | evaluation of second line anti vegf after first line anti egfr based therapy in ras wild type metastatic colorectal cancer the multicenter slave study |
| topic | <i>RAS</i> wild-type mCRC anti-angiogenics second-line treatment Aflibercept Bevacizumab Panitumumab |
| url | https://www.mdpi.com/2072-6694/12/5/1259 |
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