March 8, 2009

Avastin® plus Fluorouracil-based Chemotherapy Effective in Elderly with Metastatic Colorectal Cancer


Avastin® plus Fluorouracil-based Chemotherapy Effective in Elderly with Metastatic Colorectal Cancer

Patients aged 65 or older with metastatic colorectal cancer benefit as much from Avastin® (bevacizumab) plus fluorouracil-based chemotherapy as their younger counterparts, according to the results of a study published in the Journal of Clinical Oncology.[1]

Colorectal cancer remains the second leading cause of cancer-related deaths in the United States. Metastatic colorectal cancer refers to cancer that has spread from the colon to distant sites in the body. Metastatic colorectal cancer largely remains an incurable disease, and as such, patients are treated with the goal of extending survival and maintaining or improving quality of life.

Avastin is an anticancer drug that slows or prevents the growth of new blood vessels by inhibiting a protein known as VEGF; this deprives the cancer of oxygen and nutrients. Through its effects on blood vessels, Avastin may also improve the delivery of chemotherapy to the cancer.

Avastin has been shown to improve treatment outcomes in selected patients with advanced colorectal, breast, and non–small cell lung cancer. It is often used in combination with fluorouracil-based chemotherapy for metastatic colorectal cancer; however, because of the small number of older patients in clinical trials, the effects of Avastin in elderly patients have been unclear.

Researchers pooled the data from two randomized clinical trials that included 439 patients who were age 65 or older; 218 patients received chemotherapy plus Avastin and 221 patients received chemotherapy plus placebo. The results indicated that the response rate was 34.4% with Avastin compared with 29% with placebo. The median overall survival was 19.3 months in the Avastin group compared with 14.3 months in the placebo group. The median progression-free survival was 9.2 months in the Avastin group compared with 6.2 months in the placebo group. The rate of adverse events associated with Avastin was consistent with those reported in the two overall study groups.

The researchers concluded that the benefits of adding Avastin to fluorouracil-based chemotherapy in patients aged 65 or older “are comparable with those of the overall study population and outweigh the risks, which do not appear to be greater than those seen in younger patients with metastatic colorectal cancer.”


[1] Kabbinavar FF, Hurwitz HI, Yi J, et al. Addition of bevacizumab to fluorouracil-based first-line treatment of metastatic colorectal cancer: Pooled analysis of cohorts of older patients from two randomized clinical trials. Journal of Clinical Oncology. 2008; 27:199-205.

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