Journal of Clinical Oncology, 2008 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 26, No 15S (May 20 Supplement), 2008: 6562
© 2008 American Society of Clinical Oncology

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Abstract

Use of bevacizumab after U.S. Food and Drug Administration (FDA) approval for first-line metastatic colorectal cancer (mCRC): A Cancer Outcomes Research & Surveillance Consortium (CanCORS) study

Duke University Medical Center, Durham, NC; Durham Veterans Administration Medical Center, Durham, NC; Dana-Farber Cancer Center, Boston, MA

6562

Background: Bevacizumab improves survival in mCRC, but factors influencing its use subsequent to FDA approval in 2/2004 have not been identified. Methods: CanCORS is a multi-health system, prospective, cohort study including patients with incident colorectal cancer (CRC). Data were collected via patient interview and medical record review. Rates of bevacizumab delivery in first- line treatment of mCRC were determined via the medical record. Eligible patients for this analysis were diagnosed with stage IV disease and treated with first-line chemotherapy between 2/2004–1/2006. Medical records were abstracted for sociodemographics, stage, first treatment date, therapeutic agents delivered, and comorbidity. Of 3,311 incident CRC patients with complete record reviews, 605 (18%) had stage IV disease at diagnosis. Of these, 299 (49%) started initial chemotherapy after 2/2004, when bevacizumab was FDA-approved. Analysis focused on these 299 patients. Of the 299, 87% started first-line chemotherapy between 2/2004–2/2005. Logistic regression was used to evaluate factors associated with treatment. Results: 71% were male, 71% were 70 years, and 56% were Caucasian. Thirty-six percent had primary private insurance (non-private primary insurance included Veterans Administration, Medicare, none, and other). Using the Adult Comorbidity Evaluation-27 (ACE-27), 75% had no or mild comorbidity. Overall, 38% received bevacizumab, and 21% received first-line bevacizumab. Receipt of first-line bevacizumab was associated with having private insurance (odds ratio (OR) 2.72, p=0.01) and female gender (OR 2.23, p=0.02). No association was found between treatment with first-line bevacizumab and no/mild comorbidity (OR 2.01, p=0.06), age 70 (OR 1.53, p=0.26), and white race (OR 1.34, p=0.42). Conclusions: Over one-third of eligible patients received bevacizumab after FDA approval in 2/2004 and until 1/2006. Women and the privately insured were more likely to receive bevacizumab. Analyses of factors such as social support, employment status, and provider practice types are needed to further evaluate gender and insurance status differences in receipt of bevacizumab.

No significant financial relationships to disclose.

Abstract presentation from the 2008 ASCO Annual Meeting