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Med Oncol. 2017 Nov 4;34(12):193. doi: 10.1007/s12032-017-1049-4.

Real-world treatment patterns and effectiveness among patients with metastatic colorectal cancer treated with ziv-aflibercept in community oncology practices in the USA.

Author information

1
Analysis Group, Inc., 10 Rockefeller Plaza, 15th Floor, New York, NY, 10020, USA. jasmina.ivanova@analysisgroup.com.
2
Vector Oncology, Memphis, TN, USA.
3
Sanofi US, Bridgewater, NJ, USA.
4
Analysis Group, Inc., Boston, MA, USA.
5
Analysis Group, Inc., 10 Rockefeller Plaza, 15th Floor, New York, NY, 10020, USA.
6
Analysis Group, Inc., Montreal, QC, Canada.
7
Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA.

Abstract

Routine clinical practice data often differ from clinical trials. This study describes real-world treatment patterns and effectiveness among patients with metastatic colorectal cancer (mCRC) receiving ziv-aflibercept in non-academic, community oncology practices in the USA. De-identified electronic medical records from Vector Oncology and Altos Solutions databases were analysed. We identified 218 patients diagnosed with mCRC who had received prior oxaliplatin therapy and initiated ziv-aflibercept as part of second-line or later-line therapy. Overall survival (OS) and progression-free survival (PFS) were estimated using Kaplan-Meier analysis. Mean age was 62.8 years at ziv-aflibercept initiation. Most patients (91.7%) received bevacizumab before ziv-aflibercept, 95.4% initiated ziv-aflibercept with FOLFIRI or another irinotecan-based regimen, and 59.6% had received prior irinotecan. Overall, 24.8% of patients initiated ziv-aflibercept in second line, 31.7% in third line, 21.6% in fourth line and 22.0% in later lines of therapy. Mean duration of ziv-aflibercept treatment was 5.3 months. For patients initiating ziv-aflibercept in second-, third- and fourth-line therapy, median OS was 11.9 (95% confidence interval 5.1-16.2), 11.1 (6.9-16.7) and 8.1 (5.2-11.4) months, respectively, and median PFS was 4.4 (2.8-6.5), 4.3 (2.9-6.3) and 3.4 (2.2-5.2) months, respectively. Common adverse events (AEs) (any grade) included gastrointestinal disorders (64.7%) and asthenia/fatigue (63.3%). In routine clinical practice, ziv-aflibercept was frequently initiated in third line or later lines of therapy. Although patients receiving ziv-aflibercept were more heavily pretreated and potentially less robust compared with the VELOUR trial, median OS for patients receiving second-line ziv-aflibercept was comparable. AE rates were similar to or lower than the VELOUR trial.

KEYWORDS:

Clinical practice; Colorectal cancer; Experience; Outcomes; Post-oxaliplatin; Second line; Ziv-aflibercept; mCRC

PMID:
29103187
PMCID:
PMC5671551
DOI:
10.1007/s12032-017-1049-4
[Indexed for MEDLINE]
Free PMC Article

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