Continuing Avastin after Colorectal Cancer Gets Worse Increases Survival Time

Colorectal cancer patients benefited when they continued to include Avastin® (bevacizumab) in their chemotherapy plan after their cancer got worse after initial treatment.

They lived longer after beginning a second round of chemotherapy with Avastin than did other patients who got chemo without Avastin or those who didn’t get any chemotherapy at all.

The results are based on the ARIES study which observed patients after cancer progressed after either first or second line chemotherapy with Avastin.  The analysis will be presented at the American Society of Clinical Oncology in June.

More than 1,000 patients were followed after their cancer progressed:  either tumors began growing again or appeared in new locations.

Median survival after the first disease progression was:

  • 16.3 months for patients who continued an Avastin-based regimen
  • 8.5 months for those who received a non-Avastin containing regimen
  • 5.2 months for those who stopped therapy altogether

Side effects were similar to those seen in other clinical trials of Avastin.

  • Gastrointestinal perforations (0.2 percent)
  • Cardiovascular events caused by blood clots in arteries (1.9 percent)
  • Bleeding (3.7 percent)

Updated information, including results for progression-free and and overall survival, will be reported at the ASCO meeting.

The study confirms results of the BRiTE analysis , another observational study which also showed that continuing Avastin beyond cancer progression improved overall survival.  While interesting, results from randomized studies are required to confirm that this difference is clinically significant.

Currently iBET (Intergroup Bevacizumab Continuation Trial) is randomizing colorectal cancer patients in second-line therapy to continue with bevacizumab along with their chemotherapy or not.  Randomized clinical trials can provide stronger evidence for treatment effectiveness than observational studies which may have bias in how a therapy is chosen for an individual patient.

C3 Board Chair, Nancy Roach was one of the ARIES project reviewers, and she is an co-author of the study.

The ARIES Study Investigators concluded,

ARIES first-line metastatic colorectal cancer patient outcomes were consistent with previous reports from BRiTE. ARIES bevacizumab beyond progression (BBP) analyses affirm the BRiTE BBP data and the suggestion that continued suppression of vascular endothelial growth factor (VEGF) is an important component of improving outcomes for metastatic colorectal cancer patients.

SOURCE: Cohn et al., 2010 ASCO Annual Meeting Abstracts, #3596, Clinical outcomes in bevacizumab-treated patients with metastatic colorectal cancer. Results from ARIES observational cohort study (OCS) and confirmation of BRiTE data on bevacizumab beyond progression.

Disclosure: C3 accepts unrestricted educational grants and charitable donations from Genentech, the manufacturers of Avastin. C3 has ultimate control over website content.

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