Results of a recent study demonstrate that the proportion of patients with metastatic colorectal cancer treated with the chemotherapy regimen FOLFOXIRI and Avastin (bevacizumab) increases over time, especially in patients younger than 50 years. .
Results of this study were presented at the 2024 ASCO Gastrointestinal Cancer Symposium.
FOLFOXIRI is a chemotherapy regimen consisting of fluorouracil, leucovorin, oxaliplatin, and irinotecan that is indicated as a first-line chemotherapy option for some patients with metastatic colorectal cancer.
The results of this study also show that subsequent treatments most frequently given after first- and second-line FOLFOXIRI and Avastin include anti-epidermal growth factor receptor (EGFR) therapy, Lonsurf (trifluridine/tipiracil) and Stivarga (regorafenib) was shown to be included.
Research highlights:
- A recent study at the 2024 ASCO Symposium revealed that the combination of FOLFOXIRI and Avastin is on the rise in patients with metastatic colorectal cancer, especially in patients younger than 50 years.
- FOLFOXIRI and Avastin Combination Therapy: A chemotherapy combination consisting of fluorouracil, leucovorin, oxaliplatin, and irinotecan is recommended as first-line treatment and has been shown to improve progression-free survival.
- After FOLFOXIRI and Avastin, patients commonly received anti-EGFR therapy, Lonsurf, and Stivarga, suggesting potential for non-cytotoxic treatment beyond the first-line setting.
- Early-onset cases (<50 years) are more likely to receive aggressive chemotherapy, increasing the need for a tailored approach across age groups.
- Most patients who received FOLFOXIRI plus Avastin were between 18 and 49 years old and received the regimen primarily in the first-line setting. Understanding these patterns can provide tailored follow-up options for patients with metastatic colorectal cancer.
The median duration of first-line FOLFOXIRI plus Avastin was 25.1 weeks and 21.6 weeks for second-line regimen use. The median duration of FOLFOXIRI and Avastin combination therapy was 26.1 weeks and 23.5 weeks, respectively, for first-line therapy, regardless of KRAS mutation status. For second-line use of this regimen, the median time was 21.6 weeks for patients with KRAS mutations and 16.5 weeks for patients without specific mutations.
After first-line FOLFOXIRI and Avastin, the most frequently used new drugs include Erbitux (cetuximab) and Vectibix (panitumumab; 19%), trifluridine/tipiracil (12%), regorafenib (10%), and Xeloda. (Capecitabine; 3%). The most frequently used new drugs in the second-line setting were trifluridine/tipiracil (21%), anti-EGFR therapy (17%), regorafenib (15%), and Keytruda (pembrolizumab; 8%).
“This may suggest a role for non-cytotoxic chemotherapy, including EGFR inhibitors and regorafenib, beyond the first-line setting, and may suggest a role for non-cytotoxic chemotherapy, including EGFR inhibitors and regorafenib, in treating neutropenia, a type of white blood cell. “It could potentially be used to avoid further chemotherapy-related toxicities, such as a lower than normal number of blood cells), nausea, and diarrhea,” the study authors wrote.
In this retrospective study, researchers used information from a database from January 1, 2013 to February 28, 2023. Specifically, we evaluated the combination of FOLFOXIRI and Avastin and subsequent therapy in newly diagnosed patients aged 18 years and older. Metastatic colorectal cancer. Data for these patients were sorted by age (18–49 years, 50–64 years, and 65 years and older) and treatment strategy. Of the 24,285 patients included in the study, 38% of patients were 18 to 49 years old, 44% were 50 to 64 years old, and 19% were 65 years or older as of the index date.
“Evidence shows that patients with early onset (metastatic colorectal cancer) are more likely to receive aggressive combination chemotherapy including (FOLFOXIRI and Avastin) compared to patients with late onset. ” wrote the study authors. “Nevertheless, clinical treatment guidelines do not recommend different treatments for each age group. To tailor appropriate follow-up treatment options in this patient population, We need up-to-date evidence on the combination (of FOLFOXIRI and Avastin) and subsequent systemic treatment in patients of different ages.”
At the start of treatment, 35% were 18 to 49 years old, 29% were 50 to 64 years old, and 14% were 65 years or older. For all treatments, the combination of FOLFOXIRI and Avastin was most common among patients aged 18 to 49 years (7%), followed by patients aged 50 to 64 years (3%), and patients aged 65 years and older (1%). . Two-thirds (67%) of the patient population received FOLFOXIRI and Avastin combination therapy in their first-line setting, while 23% received this regimen in their second-line setting. Ta. Additionally, 57% were male, 34% of patients had KRAS mutations, and 23% were missing.
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