Use of FOLFOXIRI Plus Bevacizumab and Subsequent Therapies in Metastatic Colorectal Cancer: An Age-Stratified Analysis

IF 3.3 3区 医学 Q2 ONCOLOGY
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Abstract

Background

Treatment recommendations for metastatic colorectal cancer (mCRC) do not differ by age group; nevertheless, aggressive multiagent chemotherapy comprising FOLFOXIRI+bevacizumab (triplet+bev) is routinely administered in younger patients. This study analyzed real-world data on index triplet+bev use and subsequent systemic therapies.

Materials and Methods

This retrospective, observational cohort study was conducted in patients aged ≥ 18 years with mCRC, who were initiated on triplet+bev. Data were derived from the Optum de-identified electronic health record dataset.

Results

Of 36,056 patients, 14%, 36%, and 50% were aged 18-49, 50-64, and ≥ 65 years, respectively. During the study period (2010-2021), triplet+bev use increased in patients aged 18-49 years (1%-4%) but remained at approximately 3% and 1% in patients aged 50-64 and ≥ 65 years, respectively. Patient demographics and clinical characteristics varied slightly; of patients receiving triplet+bev (n = 921) versus nontriplet+bev (n = 35,132) most were male (57% vs. 52%), resided in the Midwest (54% vs. 49%) and Northeast (18% vs. 14%) US regions, and had secondary malignancies (86% vs. 73%). Following triplet+bev, most patients received subsequent therapies (including continued triplet component therapies; 97%) or subsequent “new” therapies (therapies that did not include any agents comprising triplet+bev; 57%), most frequently EGFR inhibitors (28%) and regorafenib (21%), with a similar trend among all age groups.

Conclusions

Overall, this study shows that younger patients with mCRC are more likely to receive first-line triplet+bev. These results also reveal that nonchemotherapy options are often used beyond first-line triplet chemotherapy for patients with mCRC.

在转移性结直肠癌中使用 FOLFOXIRI 加贝伐单抗及后续疗法:年龄分层分析
背景转移性结直肠癌(mCRC)的治疗建议并不因年龄组而异;然而,由 FOLFOXIRI+bevacizumab (三联+bev)组成的积极多药化疗在年轻患者中被常规使用。本研究分析了三联+贝伐指数使用和后续系统疗法的真实世界数据。材料与方法本回顾性观察队列研究的对象是年龄≥ 18 岁、开始接受三联+贝伐治疗的 mCRC 患者。结果 在 36056 名患者中,18-49 岁、50-64 岁和≥65 岁的患者分别占 14%、36% 和 50%。在研究期间(2010-2021 年),18-49 岁患者使用三联+啤酒的比例有所上升(1%-4%),但 50-64 岁和≥65 岁患者使用三联+啤酒的比例分别保持在 3% 和 1% 左右。患者的人口统计学特征和临床特征略有不同;在接受三联+贝伐(n = 921)与非三联+贝伐(n = 35,132 )的患者中,大多数为男性(57% 对 52%),居住在美国中西部(54% 对 49%)和东北部(18% 对 14%)地区,并且患有继发性恶性肿瘤(86% 对 73%)。三联+贝伐疗法后,大多数患者接受了后续疗法(包括继续三联成分疗法;97%)或后续 "新 "疗法(不包括三联+贝伐疗法中任何药物的疗法;57%),其中最常见的是表皮生长因子受体抑制剂(28%)和瑞戈非尼(21%),所有年龄组的趋势相似。这些结果还显示,在一线三联化疗之外,mCRC 患者还经常使用非化疗方案。
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来源期刊
Clinical colorectal cancer
Clinical colorectal cancer 医学-肿瘤学
CiteScore
5.50
自引率
2.90%
发文量
64
审稿时长
27 days
期刊介绍: Clinical Colorectal Cancer is a peer-reviewed, quarterly journal that publishes original articles describing various aspects of clinical and translational research of gastrointestinal cancers. Clinical Colorectal Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of colorectal, pancreatic, liver, and other gastrointestinal cancers. The main emphasis is on recent scientific developments in all areas related to gastrointestinal cancers. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.
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