ACORN: Observational Study of Bevacizumab in Combination With First-Line Chemotherapy for Treatment of Metastatic Colorectal Cancer in the UK.
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Bevacizumab
/ administration & dosage
Camptothecin
/ administration & dosage
Capecitabine
/ administration & dosage
Colorectal Neoplasms
/ drug therapy
Female
Fluorouracil
/ administration & dosage
Follow-Up Studies
Humans
Leucovorin
/ administration & dosage
Male
Middle Aged
Neoplasm Metastasis
Oxaliplatin
/ administration & dosage
Prognosis
Prospective Studies
Survival Rate
United Kingdom
Overall survival
Real world
Safety
Treatment duration
Treatment practices
Journal
Clinical colorectal cancer
ISSN: 1938-0674
Titre abrégé: Clin Colorectal Cancer
Pays: United States
ID NLM: 101120693
Informations de publication
Date de publication:
12 2019
12 2019
Historique:
received:
14
11
2018
revised:
26
04
2019
accepted:
07
07
2019
pubmed:
28
8
2019
medline:
24
7
2020
entrez:
28
8
2019
Statut:
ppublish
Résumé
Survival in metastatic colorectal cancer is worse than expected in the United Kingdom. Real-world data are needed to better understand UK-specific treatment practices that may explain this. The Avastin ColORectal Non-interventional (ACORN) study is a multicenter, prospective, UK-based, observational, phase 4 study (ClinicalTrials.gov, NCT01506167) that recruited patients with metastatic colorectal cancer scheduled to receive bevacizumab in combination with first-line chemotherapy as part of routine clinical practice. Primary end points included progression-free survival, overall survival (OS), serious adverse events (AEs), and grade 3 to 5 bevacizumab-related AEs. A total of 714 patients were recruited between August 30, 2012, and February 4, 2014. Median follow-up was 16.4 months. Median first-line chemotherapy duration was 5.6 months, with capecitabine/oxaliplatin (265 [37.1%]) being the most common regimen. Median total chemotherapy duration was 8.1 months and did not vary by geographic location in the UK. Median progression-free survival (95% confidence interval) was 8.7 (8.2-9.1) months, and median OS was 17.8 (16.1-19.3) months. There was no significant difference in efficacy by chemotherapy regimen administered. Ninety-nine patients (13.9%) received bevacizumab after disease progression. The safety profile of bevacizumab was consistent with previous studies. ACORN provided evidence that there were no clear differences observed in outcomes between bevacizumab with capecitabine-based chemotherapy and fluorouracil-based regimens, and confirmed the safety profile of bevacizumab in a real-world UK-based population. The lower-than-expected OS is likely due to the short total chemotherapy duration, less frequent use of bevacizumab after disease progression, and higher rates of in-situ primary tumors.
Identifiants
pubmed: 31451367
pii: S1533-0028(18)30546-2
doi: 10.1016/j.clcc.2019.07.003
pii:
doi:
Substances chimiques
Oxaliplatin
04ZR38536J
Bevacizumab
2S9ZZM9Q9V
Capecitabine
6804DJ8Z9U
Leucovorin
Q573I9DVLP
Fluorouracil
U3P01618RT
Camptothecin
XT3Z54Z28A
Banques de données
ClinicalTrials.gov
['NCT01506167']
Types de publication
Clinical Trial, Phase III
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
280-291.e5Subventions
Organisme : Department of Health
Pays : United Kingdom
Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.