Bevacuzimab May Be Less Effective in Obese Metastatic Colorectal Cancer Patients

Artaç, Mehmet; Korkmaz, Levent; Çoşkun, Hasan Şenol; Dane, Faysal; Karabulut, Bülent; Karaağaç, Mustafa; Çabuk, Devrim; Karabulut, Senem; Aykan, Faruk; Doruk, Hüseyin; Avcı, Nilüfer; Turhal, Nazım Serdar

doi:10.1007/s12029-017-0047-2

Cited by 16 publications

(12 citation statements)

References 24 publications

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“…It is possible that obese patients with ovarian cancer also benefit less from adjuvant bevacizumab therapy than normal weight patients; however, the data on whether this effect is due to pharmacokinetics or tumor biology is limited and unclear [53]. Comparable observations have also been reported for non-gynecological malignancies [54].…”

Section: Adjuvant Treatment Strategiesmentioning

confidence: 99%

Obesity in Gynecologic Oncology

Kölbl

Bartl

2020

Geburtshilfe Frauenheilkd

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The decades-long global obesity epidemic has resulted in steady increase in the incidence of obesity-related malignancies. The associated diagnostic and therapeutic implications present a clinical challenge for gynecologic oncology treatment strategies. Recent studies have provided solid evidence for an independent, linear, positive correlation between a pathologically increased body mass index and the probability of developing endometrial or postmenopausal breast cancer. The pathogenesis is complex and the subject of current research. Proposed causes include pathologically increased serum levels of sexual steroids and adiponectin, obesity-induced insulin resistance, and systemic inflammatory processes. The scientific evidence for an association between obesity and other gynecological malignancies is, however, less solid. The clinical relevance of obesity as a risk factor for epithelial ovarian cancer, cervical cancer and vulvar cancer appears to be negligible. Nevertheless, obesity appears to have a negative impact on prognosis and oncologic outcomes for all gynecological cancers. Whether or not this effect can be interpreted as correlative or causal is still a subject of ongoing debate.

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Section: Adjuvant Treatment Strategiesmentioning

confidence: 99%

Obesity in Gynecologic Oncology

Kölbl

Bartl

2020

Geburtshilfe Frauenheilkd

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“…There are also other trials with contradictory results [151][152][153][154][155]. In a trial investigating the influence of BMI on outcomes in advanced CRC patients receiving chemotherapy with or without targeted therapy, BMI was shown as an independent prognostic factor for survival in patients receiving chemotherapy (CT), but not in patients receiving CT plus targeted therapy [151].…”

Section: In Metastatic Diseasementioning

confidence: 99%

“…In a recent multicentric study, we demonstrated that obesity serves as a prognostic factor for mCRC patients who have been treated with bevacizumab-based regimens. In particular, among Kras wild-type left-sided tumor patients with bevacizumab-based regimens, the prognosis could be worse for obese patients than that for non-obese patients [155].…”

Section: In Metastatic Diseasementioning

confidence: 99%

Body Mass Index and Colorectal Cancer

Aykan¹,

Artaç²,

Özatlı³

2019

Body-Mass Index and Health

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Colorectal cancer (CRC) is one of the most common cancers in the world. Obesity is an established risk factor for colorectal carcinogenesis. Many epidemiological and experimental studies support this link and tumor-promoting effects of obesity. Body mass index (BMI) is a marker of general obesity. Obesity is also a global health problem and is defined by World Health Organization as BMI > 30 kg/m 2. In this chapter, we give a general review about the mechanisms of obesity on colorectal carcinogenesis and the effects of obesity on clinical outcomes such as disease-free survival (DFS), progression-free survival (PFS) and overall survival (OS), in adjuvant setting and metastatic disease, respectively.

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“…Bevacizumab is a humanized monoclonal antibody (mAb) against VEGF and in combination with chemotherapy/immunotherapy is approved for the treatment of advanced colorectal, renal cancer and non-small cell lung can-cer, as well as metastatic breast cancer [13]. Its mechanism of action is to selectively bind circulating VEGF and thus to inhibit the interaction of VEGF with its cells receptors.…”

Section: Introductionmentioning

confidence: 99%

“…By lowering interstitial pressure in tissues and increasing vascular permeability, the delivery of chemotherapeutic agents into tumor is increase and it leads to tumor endothelial cells apoptosis. On the other hand bevacizumab also causes a reduction in microvascular growth of tumor blood vessels and angiogenesis [13].…”

Section: Introductionmentioning

confidence: 99%

Overweight is associated with better prognosis in metastatic colorectal cancer patients treated with bevacizumab plus FOLFOX chemotherapy

Cybulska-Stopa¹,

Ługowska²,

Wiśniowski³

et al. 2020

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Introduction: Previous studies showed that high and low body mass index (BMI) was associated with worse prognosis in metastatic CRC (mCRC). Whether BMI is a prognostic or predictive factor in mCRC is unclear. We aimed to assess efficacy outcomes according to BMI in patient with metastatic colorectal cancer treated with bevacizumab plus FOLFOX chemotherapy regimen in second-line treatment. Material and methods: The analysis of 237 patients with metastatic colorectal cancer treated with bevacizumab plus FOLFOX in the second line (treated from January 2014 to August 2018) in 4 reference oncological centers in Poland. Results: The median age of the patients was 65 years (range 34-82). The median overall survival (OS) and progression-free survival (PFS) of the all 237 patient was 14.6 and 8.8 months, respectively. Comparison of obese patient (BMI > 30 kg/m 2) vs. overweight patients (BMI ≥ 25 to < 30 kg/m 2) vs. normal BMI range patients revealed a significant improvement of median OS (17.5 vs. 14.3 vs. 13.1 months, p = 0.01) and median PFS (9.4 vs. 9.1 vs. 7.3 months, p = 0.03). The Cox hazard model showed that the BMI class is an important risk factor. However, the Cox model also showed that the significance of the BMI class applies only to patients with BMI < 25 kg/m 2. This rule applies to both OS and PFS. The regression analysis also confirmed that there is a statistically significant relationship between the length of OS and PFS and the BMI value. Higher BMI was associated with a better prognosis. There were no differences in responses to treatment bevacizumab and FOLFOX chemotherapy and number adverse events according to BMI values. Conclusions: Patients with mCRC treated with chemotherapy with bevacizumab in second-line treatment with higher BMI compared with normal weight patients have better prognosis in terms of PFS and OS. In this group, we found no evidence of changes in safety profile depending on BMI. Nevertheless, further large randomized studies are needed to assess the body weight on the effectiveness of chemotherapy in combination with bevacizumab.

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Bevacuzimab May Be Less Effective in Obese Metastatic Colorectal Cancer Patients

Cited by 16 publications

References 24 publications

Obesity in Gynecologic Oncology

Obesity in Gynecologic Oncology

Body Mass Index and Colorectal Cancer

Overweight is associated with better prognosis in metastatic colorectal cancer patients treated with bevacizumab plus FOLFOX chemotherapy

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