Bayer HealthCare Pharmaceuticals, Whippany, NJ.
Bayer HealthCare Pharmaceuticals, Whippany, NJ.
Clin Colorectal Cancer. 2024 Sep;23(3):258-271.e1. doi: 10.1016/j.clcc.2024.05.001. Epub 2024 May 6.
Treatment recommendations for metastatic colorectal cancer (mCRC) do not differ by age group; nevertheless, aggressive multiagent chemotherapy comprising FOLFOXIRI+bevacizumab (triplet+bev) is routinely administered in younger patients. This study analyzed real-world data on index triplet+bev use and subsequent systemic therapies.
This retrospective, observational cohort study was conducted in patients aged ≥ 18 years with mCRC, who were initiated on triplet+bev. Data were derived from the Optum de-identified electronic health record dataset.
Of 36,056 patients, 14%, 36%, and 50% were aged 18-49, 50-64, and ≥ 65 years, respectively. During the study period (2010-2021), triplet+bev use increased in patients aged 18-49 years (1%-4%) but remained at approximately 3% and 1% in patients aged 50-64 and ≥ 65 years, respectively. Patient demographics and clinical characteristics varied slightly; of patients receiving triplet+bev (n = 921) versus nontriplet+bev (n = 35,132) most were male (57% vs. 52%), resided in the Midwest (54% vs. 49%) and Northeast (18% vs. 14%) US regions, and had secondary malignancies (86% vs. 73%). Following triplet+bev, most patients received subsequent therapies (including continued triplet component therapies; 97%) or subsequent "new" therapies (therapies that did not include any agents comprising triplet+bev; 57%), most frequently EGFR inhibitors (28%) and regorafenib (21%), with a similar trend among all age groups.
Overall, this study shows that younger patients with mCRC are more likely to receive first-line triplet+bev. These results also reveal that nonchemotherapy options are often used beyond first-line triplet chemotherapy for patients with mCRC.
转移性结直肠癌（mCRC）的治疗建议不因年龄组而异；然而，包含 FOLFOXIRI+bevacizumab（三联+bev）的强化多药化疗通常在年轻患者中使用。本研究分析了指数三联+bev 应用和随后系统治疗的真实世界数据。
这是一项回顾性、观察性队列研究，纳入了年龄≥18 岁的 mCRC 患者，他们开始接受三联+bev 治疗。数据来自 Optum 去识别电子健康记录数据集。
在 36056 名患者中，分别有 14%、36%和 50%的患者年龄为 18-49 岁、50-64 岁和≥65 岁。在研究期间（2010-2021 年），18-49 岁患者中三联+bev 的使用有所增加（1%-4%），但 50-64 岁和≥65 岁患者的使用比例分别约为 3%和 1%。接受三联+bev（n=921）和非三联+bev（n=35132）的患者的人口统计学和临床特征略有不同；大多数患者为男性（57% vs. 52%），居住在美国中西部（54% vs. 49%）和东北部（18% vs. 14%）地区，且患有继发性恶性肿瘤（86% vs. 73%）。接受三联+bev 治疗后，大多数患者接受了随后的治疗（包括继续使用三联治疗方案；97%）或随后的“新”治疗方案（不包括任何三联方案中的药物；57%），最常见的是 EGFR 抑制剂（28%）和regorafenib（21%），所有年龄组均呈现出类似的趋势。
总体而言，本研究表明年轻的 mCRC 患者更有可能接受一线三联+bev 治疗。这些结果还表明，对于 mCRC 患者，除一线三联化疗外，非化疗方案通常也被用于后续治疗。
