The Avastin application in clinical practice in patients with metastatic colorectal cancer: Second interim analysis of the observational AJAX program

• Main Authors: I V Poddubnaya, S A Bichurina, E V Bobrovskaya, L Yu Vladimirova, S S Gordeev, I S Davidenko, S A Emelyanov, O V Zharkova, I A Koroleva, S Yu Krasilnikova, S Ch Maikoparova, T A Malysheva, A A Modestov, A N Morozov, V A Petrukhnenko, I D Sivunova, G B Stachenko, E A Strygina, E Kh Tlish, P S Feoktistova, A S Chichkanova, N Z Sherman
• Format: Article
• Language: Russian
• Published: IP Habib O.N. 2014-03-01
• Series: Современная онкология
• Subjects: colorectal cancer; metastatic colorectal cancer; targeted therapy; bevacizumab
• Online Access: https://modernonco.orscience.ru/1815-1434/article/view/26936

The article reports the preliminary results of the observation program studying the application of bevacizumab in patients with metastatic colorectal cancer (mCRC) in daily clinical practice in Russian.Methods. The observation program is based on the results of treatment of 250 patients with metastatic colorectal cancer. The observation program included patients receiving bevacizumab from the first-line of chemotherapy. We were analyzing main demographic factors of the group of patients, survey plan before the treatment, the choice of chemotherapy regimens, dosage and reason for cessation of bevacizumab, frequency of drug usage as a supportive care.Results. The program enrolled 250 patients, where 89 (36%) patients were suffering from rectal cancer, 159 (64%) - from colonic cancer and 2 (1%) from multiple primary rectal colonic cancer. At baseline, 137 (35%) patients had synchronous distant metastases. Only in 32 (13%) patients who were enrolled in the program the primary tumor was not removed. The first-line bevacizumab-based supportive therapy was received by 120 (48%) patients. More than one line of chemotherapy was received by 47 (18,8%) patients. The median duration of bevacizumab-based treatment was 6 months. Bevacizumab therapy was discontinued in 115 (46%) patients; the main reasons for the discontinuation of bevacizumab were progression (49 patients, 43%), lack of drugs (29 patients, 25%), refusal of treatment (15 patients, 13%). During the program 48 (19%) patients developed side effects, 21 (43%) patients among them had grade 3 and 4 side effects. The analysis of treatment effects was estimated in 239 patients: 84 (35,1%) patients showed clinical (complete and partial) response. Conclusion. The targeted therapy in clinical facilities of the Russian Federation cannot be used because of scarcity supply and the oncology specialists willingness to realize the optimal therapeutic approaches. For one part, the results show that involving bevacizumab have failed to increase the toxicity of chemotherapy, for the other part the combination of bevacizumab with standard chemotherapy regimens can help to achieve high disease control rates.