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贝伐珠单抗治疗转移性结直肠癌患者的生存结果:美国社区肿瘤学的进展后治疗。

Survival outcomes of bevacizumab beyond progression in metastatic colorectal cancer patients treated in US community oncology.

机构信息

McKesson/US Oncology Healthcare Informatics, The Woodlands, TX.

出版信息

Clin Colorectal Cancer. 2012 Dec;11(4):238-46. doi: 10.1016/j.clcc.2012.05.005. Epub 2012 Jun 2.

DOI:10.1016/j.clcc.2012.05.005
PMID:22658457
Abstract

BACKGROUND

Bevacizumab prolongs OS when added to first- or second-line chemotherapy for mCRC. This retrospective analysis evaluated the association between the continued use of BBP and survival outcomes in mCRC patients treated in a community oncology setting.

PATIENTS AND METHODS

Data were derived from the US Oncology iKnowMed electronic medical record system. Patients with mCRC who received first-line bevacizumab-containing therapy between July 1, 2006 and June 30, 2009, were dichotomized into 2 second-line treatment cohorts: those receiving BBP and No-BBP. Clinical outcomes, including OS and postprogression OS (ppOS; time from start of second-line therapy to any-cause death), were calculated using Kaplan-Meier methods. A Cox proportional hazards model was used to assess the effects of patient and treatment characteristics on survival outcomes, adjusting for covariates.

RESULTS

Overall, 573 patients met the inclusion criteria for analysis-BBP (n = 267) and No-BBP (n = 306). Median OS and ppOS were longer in the BBP cohort (27.9 and 14.6 months, respectively) compared with the No-BBP cohort (21.4 and 10.1 months). According to multivariate analyses, BBP was associated with longer OS (HR, 0.76; 95% CI, 0.61-0.95) and ppOS (HR, 0.74; 95% CI, 0.60-0.93) after adjusting for potential confounders.

CONCLUSIONS

In the community oncology setting, BBP treatment was correlated with prolonged OS and ppOS in patients with mCRC. These results provide insight into real-world patterns of care and resultant bevacizumab use in this patient population.

摘要

背景

贝伐珠单抗联合一线或二线化疗可延长 mCRC 患者的 OS。本回顾性分析评估了在社区肿瘤学环境中接受治疗的 mCRC 患者继续使用贝伐珠单抗与生存结局之间的关联。

患者和方法

数据来自美国肿瘤学 iKnowMed 电子病历系统。2006 年 7 月 1 日至 2009 年 6 月 30 日期间接受一线贝伐珠单抗联合化疗的 mCRC 患者被分为 2 个二线治疗队列:接受 BBP 和未接受 BBP。采用 Kaplan-Meier 方法计算 OS 和进展后 OS(从二线治疗开始至任何原因死亡的时间)等临床结局。采用 Cox 比例风险模型评估患者和治疗特征对生存结局的影响,并调整协变量。

结果

总体而言,573 例患者符合分析纳入标准-BBP(n = 267)和未接受 BBP(n = 306)。与未接受 BBP 组相比,接受 BBP 组的中位 OS 和进展后 OS 更长(分别为 27.9 个月和 14.6 个月)。根据多变量分析,在调整潜在混杂因素后,接受 BBP 与更长的 OS(HR,0.76;95%CI,0.61-0.95)和进展后 OS(HR,0.74;95%CI,0.60-0.93)相关。

结论

在社区肿瘤学环境中,接受 BBP 治疗与 mCRC 患者的 OS 和进展后 OS 延长相关。这些结果提供了对该患者人群中真实世界治疗模式和贝伐珠单抗使用的见解。

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