Full text

Turn on search term navigation

© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Simple Summary

The current metastatic colorectal cancer guidelines suggest intensive systemic chemotherapy with a targeted agent, rather than surgical resection, as first-line treatment for primary colorectal tumor and distant metastasis. However, results of comparative efficacy between bevacizumab and cetuximab remain controversial. This study aimed to assess the effectiveness of both therapies in patients who did not undergo primary tumor resection. Among patients treated with targeted agents, primary tumor resection was associated with lower mortality among those who received both bevacizumab and cetuximab. Among patients that did not undergo primary tumor resection, multivariable analysis for conversion surgery showed that the cetuximab group had a significantly higher metastasectomy rate. In these patients, cetuximab-based therapy was associated with significantly better survival compared to bevacizumab-based therapy. Cetuximab also yielded a higher conversion surgery rate.

Abstract

Primary tumor resection may be unfeasible in metastatic colorectal cancer. We determined the effects of bevacizumab and cetuximab therapies on survival or conversion surgery in patients with metastatic colorectal cancer who did not undergo primary tumor resection. This retrospective cohort study enrolled 8466 patients who underwent first-line bevacizumab- or cetuximab-based therapy. We analyzed the data of both therapies in patients who did not undergo primary tumor resection. Overall survival after targeted therapy plus chemotherapy was assessed. The groups were matched using propensity score matching and weighting. Cetuximab resulted in lower mortality than bevacizumab (hazard ratio (HR) = 0.75); however, it did not have the same effect in patients that underwent primary tumor resection (HR = 0.95) after propensity score weighting. Among patients treated with targeted agents, primary tumor resection was associated with lower mortality among those who received both bevacizumab (HR = 0.60) and cetuximab (HR = 0.75). Among patients that did not undergo primary tumor resection, multivariable analysis for conversion surgery showed that the cetuximab group (HR = 1.82) had a significantly higher metastasectomy rate. In these patients, cetuximab-based therapy was associated with significantly better survival compared with bevacizumab-based therapy. Cetuximab also yielded a higher conversion surgery rate. These findings demonstrate the importance of stratification by primary tumor resection in the application of current treatment guidelines and initiation of future clinical trials.

Details

Title
Comparative Effectiveness of Bevacizumab versus Cetuximab in Metastatic Colorectal Cancer Patients without Primary Tumor Resection
Author
Yi-Chia, Su 1   VIAFID ORCID Logo  ; Chih-Chien, Wu 2   VIAFID ORCID Logo  ; Chien-Chou, Su 3   VIAFID ORCID Logo  ; Meng-Che Hsieh 4 ; Ching-Lan, Cheng 5   VIAFID ORCID Logo  ; Yea-Huei Kao Yang 6   VIAFID ORCID Logo 

 Department of Pharmacy, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan; [email protected]; School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan; Department of Nursing, Shu-Zen Junior College of Medicine and Management, Kaohsiung 821004, Taiwan 
 Division of Colorectal Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan; [email protected]; Department of Surgery, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan 
 Clinical Innovation Center, National Cheng Kung University Hospital, National Cheng Kung University, Tainan 701006, Taiwan; [email protected]; Department of Pharmacy, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701006, Taiwan 
 Department of Hematology and Oncology, E-Da Cancer Hospital, Kaohsiung 824005, Taiwan; [email protected]; College of Medicine, I-Shou University, Kaohsiung 824005, Taiwan 
 School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan; Department of Pharmacy, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701006, Taiwan 
 School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan; Health Outcome Research Center, National Cheng Kung University, Tainan 701401, Taiwan 
First page
2118
Publication year
2022
Publication date
2022
Publisher
MDPI AG
e-ISSN
20726694
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2662962874
Copyright
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.