No Non-Inferiority in Discontinuing Bevacizumab in Colorectal Cancer

No continuation of bevacizumab after first-line chemotherapy in patients with metastatic colorectal cancer is not non-inferior to continuation, according to a study published in Annals of Oncology.

Dieter Koeberle, MD, of the Kantonsspital St. Gallen and fellow researchers from Switzerland conducted an open-label, phase 3 multicenter trial where they looked at 262 patients with metastatic colorectal cancer.

After four to six months of standard first-line chemotherapy, patients were randomized to either continuation of bevacizumab at standard dosage or no treatment. Researchers performed CT scans every six weeks until disease progression.

They found no non-inferiority in patients who did not continue with bevacizumab treatment. Median overall survival was 25.4 months in the continuation group versus 23.8 months in the no continuation group.

In addition, the cost for bevacizumab continuation was estimated at around $30,000 per patient.

“Based on no impact on overall survival and increased treatment costs, bevacizumab as a single agent is of no meaningful therapeutic value,” the authors concluded.

Reference

1. Koeberle, D., et al. “Bevacizumab continuation versus no continuation after first-line chemotherapy plus bevacizumab in patients with metastatic colorectal cancer: a randomized phase III non-inferiority trial (SAKK 41/06).” Annals of Oncology. doi: 10.1093/annonc/mdv011. [epub ahead of print]. January 20, 2015.