Open Access Research article

Efficacy and safety of bevacizumab in elderly patients with metastatic colorectal cancer: results from the Czech population-based registry

Lubomir Slavicek1, Tomas Pavlik2, Jiri Tomasek3, Zbynek Bortlicek2, Tomas Buchler4, Bohuslav Melichar5, Rostislav Vyzula3, Jana Prausova6, Jindrich Finek7, Ondrej Majek2 and Ladislav Dusek2*

Author Affiliations

1 Department of Oncology, Hospital Jihlava, Jihlava, Czech Republic

2 Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic

3 Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic

4 Department of Oncology and First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic

5 Department of Oncology, Palacky University Medical School and Teaching Hospital, Olomouc, Czech Republic

6 Department of Oncology, Motol Hospital and Charles University, Prague, Czech Republic

7 Department of Oncology, University Hospital Pilsen, Pilsen, Czech Republic

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BMC Gastroenterology 2014, 14:53  doi:10.1186/1471-230X-14-53

Published: 25 March 2014

Abstract

Background

Patients aged 65 years and older represent the majority of patients with metastatic colorectal cancer (mCRC). However, this patient population is often underrepresented in clinical trials and probably undertreated in the clinical practice.

Methods

We have analysed the outcomes of 3,187 mCRC patients treated with first-line bevacizumab based on data from the Czech national registry of mCRC patients aiming to compare the treatment efficacy and safety according to the age categories.

Results

In total, 2,126 (66.7%), 932 (29.2%), and 129 (4.0%) patients were aged <65 years, 65 to 75 years, and 75+ years, respectively. Median progression-free survival (PFS) was 11.4, 11.3, and 11.8 months for patients aged <65 years, 65 to 75 years, and 75+ years, respectively (pā€‰=ā€‰0.94). Median overall survival (OS) was 26.9, 27.5, and 25.1 months for patients aged <65 years, 65 to 75 years, and 75+ years, respectively (pā€‰=ā€‰0.73). Using multivariable Cox model for both PFS and OS, the patient age was not significantly associated with either PFS or OS. No increase in bevacizumab-related toxicity was observed among the elderly mCRC patients with the exception of hypertension, which was observed in 71 (3.3%), 34 (3.6%), and 10 (7.8%) patients aged <65 years, 65 to 75 years, and 75+ years, respectively.

Conclusions

The results of the present study suggest similar outcome in terms of OS and PFS with bevacizumab-containing therapy in elderly mCRC patients fit for chemotherapy combined with targeted therapy compared to younger patients. Thus, chronological age should not be considered to represent a limitation in prescribing bevacizumab-containing therapy in mCRC patients.

Keywords:
Anti-angiogenic therapy; Chemotherapy; Elderly patients; Overall survival; Progression-free survival