PMID- 31451367
OWN - NLM
STAT- MEDLINE
DCOM- 20200723
LR  - 20200723
IS  - 1938-0674 (Electronic)
IS  - 1533-0028 (Linking)
VI  - 18
IP  - 4
DP  - 2019 Dec
TI  - ACORN: Observational Study of Bevacizumab in Combination With First-Line 
      Chemotherapy for Treatment of Metastatic Colorectal Cancer in the UK.
PG  - 280-291.e5
LID - S1533-0028(18)30546-2 [pii]
LID - 10.1016/j.clcc.2019.07.003 [doi]
AB  - INTRODUCTION: Survival in metastatic colorectal cancer is worse than expected in 
      the United Kingdom. Real-world data are needed to better understand UK-specific 
      treatment practices that may explain this. PATIENTS AND METHODS: The Avastin 
      ColORectal Non-interventional (ACORN) study is a multicenter, prospective, 
      UK-based, observational, phase 4 study (ClinicalTrials.gov, NCT01506167) that 
      recruited patients with metastatic colorectal cancer scheduled to receive 
      bevacizumab in combination with first-line chemotherapy as part of routine 
      clinical practice. Primary end points included progression-free survival, overall 
      survival (OS), serious adverse events (AEs), and grade 3 to 5 bevacizumab-related 
      AEs. RESULTS: A total of 714 patients were recruited between August 30, 2012, and 
      February 4, 2014. Median follow-up was 16.4 months. Median first-line 
      chemotherapy duration was 5.6 months, with capecitabine/oxaliplatin (265 [37.1%]) 
      being the most common regimen. Median total chemotherapy duration was 8.1 months 
      and did not vary by geographic location in the UK. Median progression-free 
      survival (95% confidence interval) was 8.7 (8.2-9.1) months, and median OS was 
      17.8 (16.1-19.3) months. There was no significant difference in efficacy by 
      chemotherapy regimen administered. Ninety-nine patients (13.9%) received 
      bevacizumab after disease progression. The safety profile of bevacizumab was 
      consistent with previous studies. CONCLUSION: ACORN provided evidence that there 
      were no clear differences observed in outcomes between bevacizumab with 
      capecitabine-based chemotherapy and fluorouracil-based regimens, and confirmed 
      the safety profile of bevacizumab in a real-world UK-based population. The 
      lower-than-expected OS is likely due to the short total chemotherapy duration, 
      less frequent use of bevacizumab after disease progression, and higher rates of 
      in-situ primary tumors.
CI  - Copyright (c) 2019 Elsevier Inc. All rights reserved.
FAU - Khakoo, Shelize
AU  - Khakoo S
AD  - Department of Medicine, The Royal Marsden Hospital, London & Surrey, UK.
FAU - Chau, Ian
AU  - Chau I
AD  - Department of Medicine, The Royal Marsden Hospital, London & Surrey, UK.
FAU - Pedley, Ian
AU  - Pedley I
AD  - Northern Centre for Cancer Care, Freeman Hospital, Newcastle-upon-Tyne, UK.
FAU - Ellis, Richard
AU  - Ellis R
AD  - Department of Clinical Oncology, Royal Cornwall Hospital, Truro, UK.
FAU - Steward, Will
AU  - Steward W
AD  - Leicester Cancer Research Centre, Leicester Royal Infirmary, Leicester, UK.
FAU - Harrison, Mark
AU  - Harrison M
AD  - Mount Vernon Cancer Centre, Mount Vernon Hospital, Northwood, UK.
FAU - Baijal, Shobhit
AU  - Baijal S
AD  - Department of Oncology, Heartlands Hospital, Birmingham, UK.
FAU - Tahir, Saad
AU  - Tahir S
AD  - Broomfield Hospital, Chelmsford, UK.
FAU - Ross, Paul
AU  - Ross P
AD  - Department of Oncology, Guy's and St Thomas' Hospital, London, UK.
FAU - Raouf, Sherif
AU  - Raouf S
AD  - Queen's Hospital, Romford, UK.
FAU - Ograbek, Agnes
AU  - Ograbek A
AD  - Medical Affairs, Roche Products Limited, Welwyn Garden City, UK.
FAU - Cunningham, David
AU  - Cunningham D
AD  - Department of Medicine, The Royal Marsden Hospital, London & Surrey, UK. 
      Electronic address: david.cunningham@rmh.nhs.uk.
CN  - ACORN investigators
LA  - eng
SI  - ClinicalTrials.gov/NCT01506167
GR  - DH_/Department of Health/United Kingdom
PT  - Clinical Trial, Phase III
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20190711
PL  - United States
TA  - Clin Colorectal Cancer
JT  - Clinical colorectal cancer
JID - 101120693
RN  - 04ZR38536J (Oxaliplatin)
RN  - 2S9ZZM9Q9V (Bevacizumab)
RN  - 6804DJ8Z9U (Capecitabine)
RN  - Q573I9DVLP (Leucovorin)
RN  - U3P01618RT (Fluorouracil)
RN  - XT3Z54Z28A (Camptothecin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Bevacizumab/administration & dosage
MH  - Camptothecin/administration & dosage
MH  - Capecitabine/administration & dosage
MH  - Colorectal Neoplasms/*drug therapy/pathology
MH  - Female
MH  - Fluorouracil/administration & dosage
MH  - Follow-Up Studies
MH  - Humans
MH  - Leucovorin/administration & dosage
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Metastasis
MH  - Oxaliplatin/administration & dosage
MH  - Prognosis
MH  - Prospective Studies
MH  - Survival Rate
MH  - United Kingdom
OTO - NOTNLM
OT  - Overall survival
OT  - Real world
OT  - Safety
OT  - Treatment duration
OT  - Treatment practices
EDAT- 2019/08/28 06:00
MHDA- 2020/07/24 06:00
CRDT- 2019/08/28 06:00
PHST- 2018/11/14 00:00 [received]
PHST- 2019/04/26 00:00 [revised]
PHST- 2019/07/07 00:00 [accepted]
PHST- 2019/08/28 06:00 [pubmed]
PHST- 2020/07/24 06:00 [medline]
PHST- 2019/08/28 06:00 [entrez]
AID - S1533-0028(18)30546-2 [pii]
AID - 10.1016/j.clcc.2019.07.003 [doi]
PST - ppublish
SO  - Clin Colorectal Cancer. 2019 Dec;18(4):280-291.e5. doi: 
      10.1016/j.clcc.2019.07.003. Epub 2019 Jul 11.