Role of antiangiogenic agents in the treatment of metastatic colorectal cancer

Abstract

Objective: to estimate the average duration of therapy with Avastin (bevacizumab) in patients with metastatic colorectal cancer (mCRC) in the daily clinical practice of cancer care facilities in Russia.  Methods. The observational program is being implemented on the initiative of the Russian Medical Academy for Postgraduate education RF (Moscow) and it is based on the results of treating patients with mCRC in 24 clinical centers from different regions of the Russian Federation. The observational program includes patients receiving drug treatment for mCRC in accordance with the local standards and guidelines. Program patient enrolment has not been over yet. The paper presents preliminary results. Results. As of March 1, 2013, the program enrolled 117 patients, including 43 with rectal cancer and 74 with colon cancer. At baseline 70 (60%) patients had synchronous distant metastases and 47 (40%) patients developed synchronous distant metastases after primary radical surgery. At the analysis, 112 patients were treated with bevacizumab in combination with different chemotherapy (CT) regimens; 25 patients received more than the 1 line of CT, in 8 of them bevacizumab was discontinued (because of disease progression in 6 cases); 33 (29%) patients were switched to bevacizumab monotherapy during treatment. The effect of CT with simultaneous administration of 7–10 infusions of bevacizumab was preserved in 73% of the patients; 4 and 27% showed complete and partial responses, respectively; stabilization was noted in 42%. Sixty-three (56%) patients received symptomatic therapy. Adverse events were observed in 18 (16%) pati- ents, 13 of them had grade 4 reactions.  Conclusion. Targeted therapy with bevacizumab is in considerable use in the health care facilities of the Russian Federation. The addi- tion of bevacizumab to CT does not increase toxicity of CT. The combination of bevacizumab and standard CT regimens can achieve high disease control rates.