Bevacizumab treatment in the elderly patient with metastatic colorectal cancer

Bevacizumab treatment in the elderly patient with metastatic colorectal cancer

Maria Di Bartolomeo,1 Claudia Maggi,1 Francesca Ricchini,1 Filippo Pietrantonio,1 Roberto Iacovelli,1 Filippo de Braud,1 Alessandro Inno2 1Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, 2Department of Medical Oncology, Sacro Cuore-Don Calabria Hospital, Negrar, Italy Abs...

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Autores principales: Di Bartolomeo M, Maggi C, Ricchini F, Pietrantonio F, Iacovelli R, de Braud F, Inno A
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2015
Materias:
bevacizumab
colorectal cancer
elderly
Geriatrics
RC952-954.6
Acceso en línea:https://doaj.org/article/2d6b38dad420491e9b2da6c2f7495e45
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spelling oai:doaj.org-article:2d6b38dad420491e9b2da6c2f7495e452021-12-02T06:34:38ZBevacizumab treatment in the elderly patient with metastatic colorectal cancer1178-1998https://doaj.org/article/2d6b38dad420491e9b2da6c2f7495e452015-01-01T00:00:00Zhttps://www.dovepress.com/bevacizumab-treatment-in-the-elderly-patient-withnbspmetastatic-colore-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Maria Di Bartolomeo,1 Claudia Maggi,1 Francesca Ricchini,1 Filippo Pietrantonio,1 Roberto Iacovelli,1 Filippo de Braud,1 Alessandro Inno2 1Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, 2Department of Medical Oncology, Sacro Cuore-Don Calabria Hospital, Negrar, Italy Abstract: Metastatic colorectal cancer (mCRC), like many cancers, is primarily a disease of elderly people. Despite this prevalence, such patients are often excluded from randomized trials or represent a minority of enrolled patients. Moreover, the criteria for establishing benefit or side effects of treatment strategies in this population are uncertain and not well recognized. Bevacizumab improves the outcome of mCRC when used in combination with standard first-line and second-line chemotherapy and beyond the first disease progression when given with a chemotherapy backbone different from that used in the precedent line. The particular toxicity profile of this antiangiogenesis agent (in particular hypertension, thromboembolic events, hemorrhage, and renal failure) may discourage its use in elderly patients with comorbidities. Data from subgroup analyses of randomized trials and the results of recent cohort studies suggest a significant benefit from the addition of bevacizumab to standard chemotherapy for elderly patients comparable with that observed in younger patients, except for the increased risk for thromboembolic events. Age alone should not be a barrier to use of bevacizumab, and further research with a more complete geriatric assessment should investigate the role of bevacizumab in elderly patients with mCRC to avoid undertreatment of this patient population due to a ­historical conservative approach. Keywords: bevacizumab, elderly, metastatic colorectal cancer, antivascular treatment, reviewDi Bartolomeo MMaggi CRicchini FPietrantonio FIacovelli Rde Braud FInno ADove Medical Pressarticlebevacizumabcolorectal cancerelderlyGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 10, Pp 127-133 (2015)
institution DOAJ
collection DOAJ
language EN
topic bevacizumab
colorectal cancer
elderly
Geriatrics
RC952-954.6
spellingShingle bevacizumab
colorectal cancer
elderly
Geriatrics
RC952-954.6
Di Bartolomeo M
Maggi C
Ricchini F
Pietrantonio F
Iacovelli R
de Braud F
Inno A
Bevacizumab treatment in the elderly patient with metastatic colorectal cancer
description Maria Di Bartolomeo,1 Claudia Maggi,1 Francesca Ricchini,1 Filippo Pietrantonio,1 Roberto Iacovelli,1 Filippo de Braud,1 Alessandro Inno2 1Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, 2Department of Medical Oncology, Sacro Cuore-Don Calabria Hospital, Negrar, Italy Abstract: Metastatic colorectal cancer (mCRC), like many cancers, is primarily a disease of elderly people. Despite this prevalence, such patients are often excluded from randomized trials or represent a minority of enrolled patients. Moreover, the criteria for establishing benefit or side effects of treatment strategies in this population are uncertain and not well recognized. Bevacizumab improves the outcome of mCRC when used in combination with standard first-line and second-line chemotherapy and beyond the first disease progression when given with a chemotherapy backbone different from that used in the precedent line. The particular toxicity profile of this antiangiogenesis agent (in particular hypertension, thromboembolic events, hemorrhage, and renal failure) may discourage its use in elderly patients with comorbidities. Data from subgroup analyses of randomized trials and the results of recent cohort studies suggest a significant benefit from the addition of bevacizumab to standard chemotherapy for elderly patients comparable with that observed in younger patients, except for the increased risk for thromboembolic events. Age alone should not be a barrier to use of bevacizumab, and further research with a more complete geriatric assessment should investigate the role of bevacizumab in elderly patients with mCRC to avoid undertreatment of this patient population due to a ­historical conservative approach. Keywords: bevacizumab, elderly, metastatic colorectal cancer, antivascular treatment, review
format article
author Di Bartolomeo M
Maggi C
Ricchini F
Pietrantonio F
Iacovelli R
de Braud F
Inno A
author_facet Di Bartolomeo M
Maggi C
Ricchini F
Pietrantonio F
Iacovelli R
de Braud F
Inno A
author_sort Di Bartolomeo M
title Bevacizumab treatment in the elderly patient with metastatic colorectal cancer
title_short Bevacizumab treatment in the elderly patient with metastatic colorectal cancer
title_full Bevacizumab treatment in the elderly patient with metastatic colorectal cancer
title_fullStr Bevacizumab treatment in the elderly patient with metastatic colorectal cancer
title_full_unstemmed Bevacizumab treatment in the elderly patient with metastatic colorectal cancer
title_sort bevacizumab treatment in the elderly patient with metastatic colorectal cancer
publisher Dove Medical Press
publishDate 2015
url https://doaj.org/article/2d6b38dad420491e9b2da6c2f7495e45
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