Early dissemination of bevacizumab for advanced colorectal cancer: a prospective cohort study.

Zafar SY, Malin JL, Grambow SC, Abbott DH, Schrag D, Kolimaga JT, Zullig LL, Weeks JC, Fouad MN, Ayanian JZ, Wallace R, Kahn KL, Ganz PA, Catalano P, West DW, Provenzale D, Cancer Care and Outcomes Research and Surveillance (CanCORS) Consortium. Early dissemination of bevacizumab for advanced colorectal cancer: a prospective cohort study. BMC cancer. 2011 Aug 16; 11(1):354.

Related HSR&D Project(s)

• CRS 02-164 – Colorectal Cancer Care Outcomes Research and Quality Surveillance Data System

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Abstract:

BACKGROUND: We describe early dissemination patterns for first-line bevacizumab given for metastatic colorectal cancer treatment. METHODS: We analyzed patient surveys and medical records for a population-based cohort with metastatic colorectal cancer treated in multiple regions and health systems in the United States (US). Eligible patients were diagnosed with metastatic colorectal cancer and initiated first-line chemotherapy after US Food and Drug Administration (FDA) bevacizumab approval in February 2004. First-line bevacizumab therapy was defined as receiving bevacizumab within 8 weeks of starting chemotherapy for metastatic colorectal cancer. We evaluated factors associated with first-line bevacizumab treatment using logistic regression. RESULTS: Among 355 patients, 31% received first-line bevacizumab in the two years after FDA approval, including 26% of men, 41% of women, and 16% of those 75 years. Use rose sharply within 6 months after FDA approval, then plateaued. 20% of patients received bevacizumab in combination with irinotecan; 53% received it with oxaliplatin. Men were less likely than women to receive bevacizumab (adjusted OR 0.55; 95% CI 0.32-0.93; p = 0.026). Patients 75 years were less likely to receive bevacizumab than patients < 55 years (adjusted OR 0.13; 95% CI 0.04-0.46; p = 0.001). CONCLUSIONS: One-third of eligible metastatic colorectal cancer patients received first-line bevacizumab shortly after FDA approval. Most patients did not receive bevacizumab as part of the regimen used in the pivotal study leading to FDA approval.