The Continuation of Bevacizumab Following Disease Progression in Patients with Metastatic Colorectal Cancer Offers a Survival Benefit

Background/Aims: There is little information in the literature on the use of bevacizumab (BV) combination chemotherapy in multiple lines with regimens including irinotecan and oxaliplatin, in metastatic colorectal cancer (mCRC) patients with disease progression. The aim of this small retrospective institutional study is to compare the efficacy and safety of the continuation of BV in combination with various chemotherapeutic agents, within the framework of multiple line therapy in progressed mCRC patients. Methodology: Our retrospective study included 21 patients with mCRC that had received at least one course of irinotecan-based or oxaliplatin-based chemotherapy with BV before disease progression. BV treatment was continuously dispensed after disease progression. Sub-group analysis was performed in terms of age, site of metastases, spread and co-morbidity. Results: The median overall survival (OS) was 23+ months (range 4-51 months) with no statistically significant differences between the aforementioned subgroups of patients, except from the subgroup according to spread (p=0.044). Time to progression was 17 months. Anemia (all grades) was reported in 33.3% of the patients, while hemorrhage and thrombosis were reported in 28.6% and 14.3%, respectively. Conclusions: Multiple line treatment in advanced colorectal cancer, including BV combined with standard chemotherapy, may improve OS with an acceptable toxicity profile in patients with mCRC after disease progression.