Survival of patients with liver metastases from colorectal cancer treated with bevacizumab and FOLFOX4

• Published in: Journal of B.U.ON. : official journal of the Balkan Union of Oncology Vol. 25; no. 1; p. 212
• Main Authors: Dzunic, Miljana, Andjelkovic-Apostolovic, Marija, Vrbic, Svetislav, Pejcic, Ivica, Petkovic, Ivan, Cvetanovic, Ana, Dinic, Sasa
• Format: Journal Article
• Language: English
• Published: Greece 01-01-2020
• Subjects: Antineoplastic Combined Chemotherapy Protocols - pharmacology; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bevacizumab - pharmacology; Bevacizumab - therapeutic use; Colorectal Neoplasms - complications; Colorectal Neoplasms - drug therapy; Colorectal Neoplasms - mortality; Colorectal Neoplasms - pathology; Female; Fluorouracil - pharmacology; Fluorouracil - therapeutic use; Humans; Leucovorin - pharmacology; Leucovorin - therapeutic use; Liver Neoplasms - drug therapy; Liver Neoplasms - mortality; Liver Neoplasms - pathology; Liver Neoplasms - secondary; Male; Middle Aged; Neoplasm Metastasis; Organoplatinum Compounds - pharmacology; Organoplatinum Compounds - therapeutic use; Survival Analysis; Treatment Outcome
• ISSN: 2241-6293

Purpose: In patients with colorectal liver metastases (CLM) a long term survival and a probability of cure might be achieved with the surgical treatment of metastatic sites after prior application of systemic treatment. The purpose of this study was to assess the survival of patients with unresectable CLM treated with bevacizumab (bev) and FOLFOX4 (FOLFOX-bev) and to compare survival according to patient, disease and treatment characteristics.
Methods: This research included 110 patients with unresectable CLM treated with FOLFOX-bev. Treatment response and resectability were estimated every 3 months. If resectability was achieved, patients were operated on and followed. Patient, disease and treatment characteristics in patients with and without hepatectomy were compared. Survival was estimated according to Kaplan-Meier method. Comparison of survival according to patient, disease and treatment characteristics was performed using log-rank test.
Results: In patients with hepatectomy, treatment response was significantly more frequent (63, 63% vs 16, 66%, p<0.001). One- and three-year survival rate for the whole group was 87, 3% and 36, 1%, respectively; median overall survival (OS) was 23 months (95%CI 19, 63-28, 26). One- and three-year survival for patients with hepatectomy was 98, 48%, and 54, 76%, respectively; median OS was 35 months (95%CI 28, 83-41, 17). Three-year survival was significantly better in patients with hepatectomy (HR=3.775; 95%CI 2.150-6.627, p<0.001), older than 60 years (p=0.033), those without extrahepatic metastases (p=0.008) and those with treatment response (p=0.05).
Conclusion: Significantly better survival had patients with hepatectomy, treatment response, older than 60 years and without extrahepatic metastases. FOLFOX4-bev is effective treatment for molecularly unselected patients.