Efficacy and toxicity of aflibercept and bevacizumab in combination with FOLFIRI in second‑line therapy for metastatic colon cancer: a retrospective multicenter study

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Abstract

Objective: to compare the efficacy and toxicity of aflibercept and bevacizumab in combination with fOLfIRI in secondline therapy for patients with metastatic colon cancer.
Materials and methods. we performed a retrospective analysis of data on patients with metastatic colon cancer treated in 9 clinics in the Russian federation. The inclusion criteria were as follows: metastatic or locally advanced colon cancer; treatment with bevacizumab or aflibercept plus fOLfIRI in the second-line therapy. The primary outcome measure was progression-free survival (PfS). Secondary outcome measures included objective response rate and incidence of adverse events.
Results. A total of 271 patients with metastatic colon cancer who received second-line therapy with bevacizumab (n = 81) or aflibercept (n = 190) between 2014 and 2018 were selected for this study. Study groups were matched for main prognostic signs. The objective response rate was 18.1 % in the bevacizumab group and 20.5 % in the aflibercept group (p = 0.7). The median PfS was 5 months (95 % confidence interval 3.8–6.1) in the aflibercept group and 7 months (95 % confidence interval 0.81–2.1) in the bevacizumab group (hazard ratio 1.4; 95 % confidence interval 0.99–2.1; p = 0.04). multivariate regression analysis demonstrated that the type of the targeted drug independently had no effect on PfS (hazard ratio 1.3; 95 % confidence interval 0.9–1.9; p = 0.2). we observed no statistically significant differences in the incidence of complications of any grades between the groups (58 % vs 72 %, p = 0.1). Patients receiving aflibercept were more likely to develop grade III–Iv arterial hypertension (2 % vs 9.5 %) and diarrhea (0 % vs 5.4 %), whereas thrombotic complications were more common in the bevacizumab group (10 % vs 1.8 %).
Conclusion. we observed no significant differences in objective response rate and PfS between patients with metastatic colon cancer receiving bevacizumab or aflibercept in combination with fOLfIRI as second-line therapy. The toxicity profiles were different. Our findings can be used for choosing an optimal targeted drug for second-line treatment.

About the authors

M.   Yu. Fedyanin

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Author for correspondence.
Email: fedianinmu@mail.ru
ORCID iD: 0000-0001-5615-7806

Mikhail Yuryevich Fedyanin 

24 Kashirskoe Shosse, Moscow 115478

Russian Federation

L.  Yu.  Vladimirova

National Medical Research Center of Oncology, Ministry of Health of Russia

63/2 14-ya Liniya, Rostov-on-Don 344019

Russian Federation

V.  A.  Chubenko

Saint Petersburg Clinical Research Center for Specialized Medical Care (Oncology), Ministry of Health of Russia

68A Leningradskaya St., Pesochnyy, Saint Petersburg 197758

Russian Federation

L.   A. Zagorskaya

Saint Petersburg Clinical Research Center for Specialized Medical Care (Oncology), Ministry of Health of Russia

68A Leningradskaya St., Pesochnyy, Saint Petersburg 197758

Russian Federation

A.  V.  Belyaeva

Saint Petersburg Clinical Research Center for Specialized Medical Care (Oncology), Ministry of Health of Russia

68A Leningradskaya St., Pesochnyy, Saint Petersburg 197758

Russian Federation

O.  L.  Fakhrutdinova

Saint Petersburg Clinical Research Center for Specialized Medical Care (Oncology), Ministry of Health of Russia

68A Leningradskaya St., Pesochnyy, Saint Petersburg 197758

Russian Federation

S.  A.  Belukhin

Saint Petersburg Clinical Research Center for Specialized Medical Care (Oncology), Ministry of Health of Russia

68A Leningradskaya St., Pesochnyy, Saint Petersburg 197758

Russian Federation

A.   S. Zhabina

Saint Petersburg Clinical Research Center for Specialized Medical Care (Oncology), Ministry of Health of Russia

68A Leningradskaya St., Pesochnyy, Saint Petersburg 197758

Russian Federation

L.   V. Khalikova

Saint Petersburg Clinical Research Center for Specialized Medical Care (Oncology), Ministry of Health of Russia

68A Leningradskaya St., Pesochnyy, Saint Petersburg 197758

Russian Federation

L.  V.  Bolotina

P. A. Herzen Moscow Oncology Research Institute – a branch of the National Medical Radiology Research Center, Ministry of Health of Russia

3 2-oy Botkinskiy Proezd, Moscow 125284

Russian Federation

R.   V. Orlova

Saint Petersburg State University

7/9 Universitetskaya Naberezhnaya, Saint Petersburg 199034

Russian Federation

F.  V.  Moiseenko

Saint Petersburg Clinical Research Center for Specialized Medical Care (Oncology), Ministry of Health of Russia; Saint Petersburg State University

68A Leningradskaya St., Pesochnyy, Saint Petersburg 197758

7/9 Universitetskaya Naberezhnaya, Saint Petersburg 199034

Russian Federation

G.   Z. Mukhametshina

Republican Clinical Oncology Dispensary, Ministry of Health of the Republic of Tatarstan

29 Sibirskiy Trakt, Kazan 420029, Republic of Tatarstan

Russian Federation

A.  I.  Khasanova

Republican Clinical Oncology Dispensary, Ministry of Health of the Republic of Tatarstan

29 Sibirskiy Trakt, Kazan 420029, Republic of Tatarstan

Russian Federation

A.  V.  Belonogov

Medsi Group of Companies, Clinical Hospital No. 1 «Medsi»

2/1A Pyatnitskoe shosse 6 km, Otradnoye, Moscow region 143442

Russian Federation

Kh.  S.  Musaeva

Republican Oncology Dispensary

81 Leonova St., Grozny 366007, Chechen Republic

Russian Federation

O.  Yu.  Novikova

Regional Clinical Oncology Center

164 Voronezhskaya St., Khabarovsk 680035

Russian Federation

 I.  Yu.  Stradaeva

Moscow Regional Oncology Dispensary

6 Karbysheva St., Balashikha 143900

Russian Federation

I.  L.  Popova

Saint Petersburg Clinical Oncology Dispensary

56 Prospekt Veteranov, Saint Petersburg 198255

Russian Federation

S.  P.  Erdniev

Saint Petersburg Clinical Oncology Dispensary

56 Prospekt Veteranov, Saint Petersburg 198255

Russian Federation

A.  K.  Ivanova

Saint Petersburg Clinical Oncology Dispensary

56 Prospekt Veteranov, Saint Petersburg 198255

Russian Federation

A.  V.  Androsova

Saint Petersburg Clinical Oncology Dispensary

56 Prospekt Veteranov, Saint Petersburg 198255

Russian Federation

P.  S.  Feoktistova

Nizhnevartovsk Oncology Dispensary

9a Sportivnaya St., Nizhnevartovsk 628615

Russian Federation

E.  S.  Kuzmina

Salekhard Regional Clinical Hospital

39 Mira St., Salekhard 629001

Russian Federation

E.   V. Karabina

Tula Regional Oncology Dispensary

201A Plekhanova St., Tula 300040

Russian Federation

O.  V.  Nekrasova

Multicare Medical Center “Medical City”

32 Barnaulskaya St., Tyumen 625041

Russian Federation

O.  V.  Sekhina

Oncology Dispensary No. 5, Moscow Healthcare Department

5/1 Perervinskiy Bulvar, Moscow 109451

Russian Federation

A.   A. Mishchenko

Primorsky Regional Oncology Dispensary

57A Russkaya St., Vladivostok 690069

Russian Federation

L.  A.  Mukova

Oncology Dispensary, Ministry of Health of Kabardino-Balkar Republic

23 Lermontova St., Nalchik 360000, Kabardino-Balkar Republic

Russian Federation

B.  Kh.  Kertiev

Oncology Dispensary, Ministry of Health of Kabardino-Balkar Republic

23 Lermontova St., Nalchik 360000, Kabardino-Balkar Republic

Russian Federation

G.  I.  Kosar

Oncology Dispensary

46/45 Pervomayskiy Per., Volgodonsk 347360

Russian Federation

S.   N. Osodoeva

Buryat Republican Oncology Dispensary

32 Pirogova St., Ulan-Ude 670047

Russian Federation

A.  I.  Kats

Oncology Dispensary

23 Sholom-Aleykhema St., Birobidzhan 679016

Russian Federation

R.  R.  Malina

Oncology Dispensary

23 Sholom-Aleykhema St., Birobidzhan 679016

Russian Federation

M.  A.  Lyadova

City Clinical Oncology Hospital No. 1 Moscow Healthcare Department

18A Zagorodnoe Shosse, Moscow 117152

Russian Federation

A.  A.  Tryakin

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

ORCID iD: 0000-0003-2245-214X

24 Kashirskoe Shosse, Moscow 115478

Russian Federation

S.  A.  Tyulandin

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

ORCID iD: 0000-0001-9807-2229

24 Kashirskoe Shosse, Moscow 115478

Russian Federation

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Copyright (c) 2022 Fedyanin M. ., Vladimirova L.Y., Chubenko V.A., Zagorskaya L.A., Belyaeva A.V., Fakhrutdinova O.L., Belukhin S.A., Zhabina A.S., Khalikova L.V.,  Bolotina L.V., Orlova R.V.,  Moiseenko F.V., Mukhametshina G.Z., Khasanova A.I.,  Belonogov A.V.,  Musaeva K.S., Novikova O.Y., Stradaeva  .Y., Popova I.L.,  Erdniev S.P., Ivanova A.K., Androsova A.V., Feoktistova P.S., Kuzmina E.S., Karabina E.V., Nekrasova O.V., Sekhina O.V., Mishchenko A.A., Mukova L.A., Kertiev B.K.,  Kosar G.I., Osodoeva S.N., Kats A.I., Malina R.R., Lyadova M.A., Tryakin A.A.,  Tyulandin S. .

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