Cited by 38Colorectal Cancer Treatments and StudiesColorectal Cancer Surgical TreatmentsIntraperitoneal and Appendiceal Malignancies

The DOI matches its Crossref record; 23 of the 23 references it cites were found in a registry or an index.

Efficacy and safety of FOLFIRI/aflibercept in second-line treatment of metastatic colorectal cancer in a real-world population: Prognostic and predictive markers

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Fernández Montes, Ana, Martínez Lago, Nieves, Covela Rúa, Marta, de la Cámara Gómez, Juan, González Villaroel, Paula, Méndez Méndez, José Carlos, Jorge Fernández, Mónica, Salgado Fernández, Mercedes, Reboredo López, Margarita, Quintero Aldana, Guillermo, Luz Pellón Augusto, María, Graña Suárez, Begoña, García Gómez, Jesús·2019·Cancer Medicine

Abstract

Purpose: The phase III VELOUR trial demonstrated efficacy with combined FOLFIRI‐aflibercept in patients with metastatic colorectal cancer previously treated with oxaliplatin with or without bevacizumab versus placebo. The effect of FOLFIRI‐aflibercept in routine clinical practice was evaluated. Methods/Patients: Overall survival (OS), progression‐free survival (PFS), response and safety were analysed for 78 patients treated with FOLFIRI‐aflibercept at six GITuD institutions. Exploratory analyses of prognostic and predictive markers of efficacy were performed. Results: Patients had good general status (PS 0‐1 96.2%), tumours were mostly RAS‐mutant (75.6%), synchronous (71.8%), and left‐sided (71.8%). Prior therapy included bevacizumab (47.4%) and anti‐EGFR agents (12.8%). PFS was longer for metachronous than synchronous tumours (11.0 vs 5.0 months, P = 0.028), and for left‐colon tumours (7.0 vs 3.0 months, P = 0.044). RAS‐mutant status, first‐line treatment and primary tumour surgery did not impact PFS. The disease control rate was 70.5%. The most common grade 3/4 toxicities were neutropenia (15.3%), asthenia (10.3%), diarrhea and mucositis (6.4% each). Dysphonia was reported in 39.7% of patients, and grade 3 hypertension in 3.8%. Development of hypertension (any grade) was significantly associated with a reduced risk of progression by multivariate analysis (HR = 2.7; 95%CI 1.3‐5.4; P = 0.001). Conclusions: Efficacy with FOLFIRI‐aflibercept in a real‐life population was in line with results from the pivotal trial and toxicity was manageable with treatment adaptation. Survival outcomes were not impacted by primary tumour location, RAS‐mutant status, first‐line treatment or primary tumour surgery. Hypertension may be a surrogate marker of efficacy in this patient population.

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Figure 1 Kaplan‐Meier curves for progression‐free survival and overall survival according to metastasis pattern (A) and laterality (B)
Figure 1 Kaplan‐Meier curves for progression‐free survival and overall survival according to metastasis pattern (A) and laterality (B)CC BY · PubMed Central
Figure 2 Kaplan‐Meier curves for progression‐free survival and overall survival according to the presence of hypertension (HTA)
Figure 2 Kaplan‐Meier curves for progression‐free survival and overall survival according to the presence of hypertension (HTA)CC BY · PubMed Central

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Authors
Fernández Montes, A., Martínez Lago, N., Covela Rúa, M., de la Cámara Gómez, J., González Villaroel, P., Méndez Méndez, J. C., Jorge Fernández, M., Salgado Fernández, M., Reboredo López, M., Quintero Aldana, G., Luz Pellón Augusto, M., Graña Suárez, B., & García Gómez, J.
Affiliations
  • University Hospital of Ourense Ourense Spain
  • University Hospital of A Coruña A Coruña Spain
  • Universital Hospital Lucus Augusti Lugo Spain
  • University Hospital Arquitecto Marcide Ferrol Spain
  • Oncological Center of Galicia A Coruña Spain
  • Univerity Hospital Álvaro Cunqueiro Vigo Spain
Venue
Cancer Medicine
Publisher
Wiley
Published
2019-01-28
Volume
8
Issue
3
Pages
882-889
ISSN
2045-7634 (ISSN-L)
OpenAlex
W2913408083
Cited by
38
References
23
Citations by year
2026: 2 · 2025: 2 · 2024: 3 · 2023: 6 · 2022: 8 · 2021: 6 · 2020: 9 · 2019: 2
FWCI
2.61
Type
journal article
Language
en
Open access
Locations
  • Cancer Medicine (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • RUNA. Repositorio Institucional del Sergas (Servicio Gallego de Salud (SERGAS)) (submittedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Oncology › Colorectal Cancer Treatments and Studies
  • Health Sciences › Medicine › Oncology › Colorectal Cancer Surgical Treatments
  • Health Sciences › Medicine › Surgery › Intraperitoneal and Appendiceal Malignancies
Keywords
FOLFIRI, aflibercept, metastatic colorectal cancer, second-line therapy, real-world evidence, prognostic factors, predictive biomarkers, RAS mutations, synchronous and metachronous metastases, primary tumour location, hypertension, treatment toxicity, progression-free survival, overall survival, anti-VEGF therapy
MeSH terms
Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, Camptothecin, Leucovorin, Female, Fluorouracil, Humans, Liver Neoplasms, Male, Middle Aged, Recombinant Fusion Proteins, Retrospective Studies, Colorectal Neoplasms, Survival Rate, Treatment Outcome, Receptors, Vascular Endothelial Growth Factor, Biomarkers, Pharmacological

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