PMID- 35116988 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220501 IS - 2219-6803 (Electronic) IS - 2218-676X (Print) IS - 2218-676X (Linking) VI - 8 IP - 6 DP - 2019 Oct TI - An observational study of vascular endothelial growth factor inhibitors as second-line treatment for metastatic colorectal cancer treated with bevacizumab plus FOLFIRI beyond progression: the association with RAS mutation and tumor sidedness. PG - 2357-2370 LID - 10.21037/tcr.2019.09.59 [doi] AB - BACKGROUND: The BRiTE and ARIES studies suggested that the continued use of bevacizumab beyond progression (BBP) was beneficial. This study investigated the efficacy and safety of the vascular endothelial growth factor inhibitors (VEGFis) bevacizumab and aflibercept as second-line treatments for patients with metastatic colorectal cancer (mCRC) that progressed following the application of bevacizumab-containing chemotherapy as a first-line treatment. METHODS: This observational cohort study (OCS) analyzed the medical records of 73 patients with mCRC divided into a no-VEGFi group (n=48) and a VEGFi group (n=25). Progression-free survival (PFS) was the primary endpoint, and the overall survival (OS), objective response rate (ORR), disease control rate (DCR), and safety were secondary endpoints. RESULTS: The results revealed that the PFS, ORR, and DCR of the VEGFi group were significantly superior to those of the no-VEGFi group, even in those with wild-type and mutant-type RAS or left-sided mCRC (all P<0.05); however, OS did not differ significantly between the two groups (all P>0.05). Patients with primary left-sided lesions and continued use of VEGFi exhibited the most marked effect on PFS (P=0.001). No significant differences were observed in the incidence of grade 3 or 4 adverse events (AEs) between the two groups (P=0.133). CONCLUSIONS: These results support the use of VEGFi as a second-line treatment after bevacizumab beyond the initial progression in this OCS. Bevacizumab or aflibercept combined with second-line chemotherapy in mCRC has an acceptable safety profile and is relatively active. Regardless of the RAS gene type, VEGFi plus FOLOFX6 exhibited superior PFS to that of FLFOX6 as a second-line treatment, and a greater improvement in PFS was obtained for the left-sided lesions than for the right-sided lesions. CI - 2019 Translational Cancer Research. All rights reserved. FAU - Tsai, Hsiang-Lin AU - Tsai HL AD - Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung. AD - Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung. FAU - Huang, Ching-Wen AU - Huang CW AD - Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung. AD - Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung. FAU - Ma, Cheng-Jen AU - Ma CJ AD - Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung. AD - Division of General and Digestive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung. FAU - Su, Wei-Chih AU - Su WC AD - Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung. FAU - Chang, Tsung-Kun AU - Chang TK AD - Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung. FAU - Chen, Po-Jung AU - Chen PJ AD - Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung. AD - Department of Surgery, Kaohsiung Municipal Hsiaokang Hospital, Kaohsiung. FAU - Yeh, Yung-Sung AU - Yeh YS AD - Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung. AD - Division of Trauma and Critical Care, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung. FAU - Wang, Jaw-Yuan AU - Wang JY AD - Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung. AD - Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung. AD - Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung. AD - Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung. AD - Center for Cancer Research, Kaohsiung Medical University, Kaohsiung. LA - eng PT - Journal Article PL - China TA - Transl Cancer Res JT - Translational cancer research JID - 101585958 PMC - PMC8798720 OTO - NOTNLM OT - RAS mutation OT - Vascular endothelial growth factor inhibitor (VEGFis) OT - bevacizumab beyond progression (BBP) OT - second-line treatment OT - tumor sidedness COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tcr.2019.09.59). The authors have no conflicts of interest to declare. EDAT- 2019/10/01 00:00 MHDA- 2019/10/01 00:01 PMCR- 2019/10/01 CRDT- 2022/02/04 05:50 PHST- 2019/04/25 00:00 [received] PHST- 2019/09/12 00:00 [accepted] PHST- 2022/02/04 05:50 [entrez] PHST- 2019/10/01 00:00 [pubmed] PHST- 2019/10/01 00:01 [medline] PHST- 2019/10/01 00:00 [pmc-release] AID - tcr-08-06-2357 [pii] AID - 10.21037/tcr.2019.09.59 [doi] PST - ppublish SO - Transl Cancer Res. 2019 Oct;8(6):2357-2370. doi: 10.21037/tcr.2019.09.59.