Safety and efficacy of first-line bevacizumab with FOLFOX, XELOX, FOLFIRI and fluoropyrimidines in metastatic colorectal cancer: the BEAT study

Abstract

The BEAT study shows that the efficacy and safety profile of bevacizumab in routine clinical practice is consistent with results observed in prospective randomised clinical trials and another large observational study in the United States (BRiTE study).

Predictive Significance of VEGF and HIF-1α Expression in Patients with Metastatic Colorectal Cancer Receiving Chemotherapy Combinations with Bevacizumab

“…Response rates did not change with the addition of bevacizumab. In the following BEAT and BRITE observational studies, it was shown that endpoint results were significantly improved and adverse effect profile was tolerable with the addition of bevacizumab to the treatment of metastatic colorectal cancer (Kozloff et al, 2009,Van Cutsem et al, 2009. As it seen from these studies, survival and treatment efficacy were improved with the addition of bevacizumab to 5-FU, irinotecan and oxaliplatin.…”

XELOX Plus Bevacizumab vs. FOLFIRI Plus Bevacizumab Treatment for First-line Chemotherapy in Metastatic Colon Cancer: a Retrospective Study of the Anatolian Society of Medical Oncology

“…Investigators reported that all response rate was 44.4-67.5%, complete response rate was 2-2.5%, partial response rate was 13-65%, stable disease was 22.5-25% and progressive disease rate was 2.5-8% in patients who received XELOX-Bev (Van Cutsem et al, 2009;Diaz-Rubio et al, 2012;Uchima et al, 2014;Buchler et al, 2014). In different studies, investigators reported various partial response rates such as 47.5 (Becouarn et al, 2014), 40.1% (Pectasides et al, 2012) and 36.8% (Stathopoulos et al, 2010) with FOLFIRI-Bev.…”

“…The rate of severe toxic effects in patients treated with XELOX-Bev were: sensory neuropathy 15-26%, diarrhea 0-21%, fatigue 10-15%, hypertension 0-4%, gastrointestinal perforation <0.01, bleeding <0.01 (Hochster et al, 2008;Tol et al, 2009;Diaz-Rubio et al, 2012;Uchima et al, 2014). In the literature, investigators reported the rate of severe (grade 3-4) toxic effects in patients treatment with FOLFIRI-Bev were as follows: neutropenia 16.1% to 53.6, diarrhea (2-11.3%), mucositis (5.3%), astenia (2.1%), gastrointestinal perforation 0% to 2%, bleeding 0%-11.6%, proteinuria 1%; hypertension 5% to 12.5%; and venous thromboembolism 1% and 19% (Fuchs et al, 2007;Van Cutsem et al, 2009;Becouarn et al, 2014;Hasegawa et al, 2014). In the present study, grade 3 or 4 neutropenia (5% vs 30.6) and mucositis (0 vs 3.6%) were statistically significantly less common in patients who received XELOX-Bev than in those who received FOLFIRI-Bev (Table 1).…”

Anti-VEGF Therapies in the Clinic

“…In high-risk settings, when patients undergo emergent surgery usually involving a large laparotomy for complications of cancer progression, the risk of surgical complications appears to be increased from 3% to 13%. Under more controlled circumstances, such as elective resection of liver metastases where bevacizumab is discontinued at least a month before surgery, the rate of surgical complications does not appear to be increased compared with historical controls (Grothey et al 2008;Kesmodel et al 2008;Van Cutsem et al 2009a).…”