FOLFIRI plus BEvacizumab or aFLIbercept after FOLFOX-bevacizumab failure for COlorectal cancer (BEFLICO): an AGEO multicenter study
Menée en France à partir de données portant sur un total de 681 patients atteints d'un cancer colorectal métastatique (âge médian : 64,2 ans ; durée médiane de suivi : 31,2 mois), cette étude de cohorte rétrospective et multicentrique compare l'efficacité, du point de vue de la survie globale, et la toxicité du bévacizumab par rapport à l'aflibercept, dispensés en combinaison avec une chimiothérapie de seconde ligne de type FOLFIRI
After failure of first line FOLFOX-bevacizumab for metastatic colorectal cancer (mCRC), adding either bevacizumab or aflibercept to second-line FOLFIRI increases survival compared to FOLFIRI alone. In this French retrospective multicentre cohort, we included patients with a mCRC treated with either FOLFIRI-aflibercept or FOLFIRI-bevacizumab. The primary endpoint was overall survival (OS), and secondary endpoints were progression-free survival (PFS), disease control rate (DCR: CR+PR+SD) and safety. We included 681 patients from 36 centers, 326 and 355 in the aflibercept and bevacizumab group, respectively. Median age was 64.2 years and 45.2% of patients were men. Most patients had RAS-mutated tumors (80.8%) and synchronous metastases (85.7%). After a median follow up of 31.2 months, median OS was 13.0 months (95%CI: 11.3-14.7) and 10.4 months (95%CI: 8.8-11.4) in the bevacizumab and aflibercept groups, respectively (P<0.0001). Median PFS was 6.0 months (95%CI: 5.4-6.5) and 5.1 months (95%CI: 4.3-5.6) (P<0.0001). After adjustment on age, PS, PFS of first line, primary tumor resection, metastasis location and RAS/BRAF status, bevacizumab was still associated with better OS (HR: 0.71, 95%CI: 0.59-0.86, P=0.0003). FOLFIRI-bevacizumab combination was associated with longer OS and PFS, and a better tolerability, as compared with FOLFIRI-aflibercept after progression on FOLFOX-bevacizumab. This article is protected by copyright. All rights reserved.