Key clinical point: Sequential vs concurrent administration of bevacizumab and chemotherapy failed to improve objective response rate (ORR) in patients with metastatic colorectal cancer (mCRC), but was associated with survival advantage and fewer adverse effects.
Major finding: ORR (odds ratio, 0.96; P = .89) was not significantly different among patients who received bevacizumab and chemotherapy concurrently or sequentially. However, sequential administration was associated with survival benefit (adjusted hazard ratio, 0.73; P = .04), significantly reduced rates of severe diarrhea (5.3% vs 16.5%; P = .006), and improved physical functioning at cycle 12 ( P = .02).
Study details: Findings are from OBELICS, a phase 3 trial including 230 patients with unresectable, previously untreated, or single line-treated mCRC who were randomly assigned to receive 12 biweekly cycles of standard oxaliplatin-based regimens and bevacizumab administered either concurrently with chemotherapy or sequentially (4 days before chemotherapy).
Disclosures: The trial was supported by the Italian Ministry of Health. Some of the authors reported receiving personal fees, research grants, consulting or advisory fees, and/or nonfinancial support from various sources.
Source: Avallone A et al. JAMA Netw Open. 2021 Jul 26. doi: 10.1001/jamanetworkopen.2021.18475 .