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Clin Transl Oncol ; 25(5): 1455-1462, 2023 May.
Article in English | MEDLINE | ID: mdl-36723787

ABSTRACT

INTRODUCTION: The second-line chemotherapy in metastatic colorectal cancer (mCRC) with FOLFIRI-aflibercept demonstrated an increase in survival compared with FOLFIRI in patients previously treated with oxaliplatin-based regimens. Few data are available in patients treated previously with bevacizumab. Our objective is to evaluate the efficacy and safety of FOLFIRI-aflibercept in second-line treatment in patients who have previously received bevacizumab. PATIENTS AND METHODS: This is a observational, retrospective study of patients with mCRC treated with FOLFIRI-aflibercept in 2nd line in eight hospitals in the Valencian Community. Survival, response, and toxicity were analyzed. RESULTS: 122 patients with a median age of 61 years were included. 89% of patients had PS 0-1. The median of PFS (progression free survival) and OS (overall survival) was 5.45 (95% CI 4.74-6.15 months) and 10.15 (95% CI 7.47-12.82 months), respectively. Disease control rate 59.8%. The most common grade 3-4 adverse events were neutropenia (13,1%) and asthenia (9%). The presence of hypertension during treatment with FOLFIRI-aflibercept was associated with a survival benefit. Median of OS was 14.45 (95% CI 11.58-17.32) in patients with hypertension vs 7.78 (95% CI 5.02-10.54) in patients without hypertension (p = .001). Our results suggest that the presence of PS 0, primary tumor surgery, metachronous metastases, and the presence of only 1 metastatic location, are favorable prognostic factors associated with better OS. CONCLUSIONS: Our results confirm the value of maintaining angiogenesis inhibition with FOLFIRI-aflibercept in mCRC after progression to a first-line treatment with bevacizumab. The development of hypertension during treatment is a possible predictive marker of response.


Subject(s)
Colonic Neoplasms , Colorectal Neoplasms , Hypertension , Rectal Neoplasms , Humans , Middle Aged , Bevacizumab/therapeutic use , Colorectal Neoplasms/pathology , Camptothecin/therapeutic use , Retrospective Studies , Fluorouracil/adverse effects , Colonic Neoplasms/drug therapy , Recombinant Fusion Proteins/therapeutic use , Rectal Neoplasms/drug therapy , Hypertension/chemically induced , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Leucovorin/therapeutic use , Neoplasm Metastasis/drug therapy
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