Afr Am Fare Worse  Bevacizumab (Avastin) Colorectal Ca Study

ASCO: African Americans Fare Worse in Bevacizumab (Avastin) Colorectal Cancer Study

By Crystal Phend, Staff Writer, MedPage Today

Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine. June 07, 2007

African Americans with metastatic colorectal cancer do not fare as well as Caucasians when bevacizumab (Avastin) is added to the FOLFOX regimen, investigators reported here.

So found an analysis of data from the trial that established the efficacy of adding bevacizumab to the FOLFOX regimen, said biostatistician Paul Catalano, D.Sc., of the Harvard School of Public Health and the Dana-Farber Cancer Institute in Boston.

"These results suggest differences in outcomes on the basis of race in the treatment of patients with metastatic colorectal cancer," he said at the American Society of Clinical Oncology meeting.

Yet Dr. Catalano, who analyzed results of the Eastern Cooperative Oncology Group's E3200 trial, said that he and his colleagues were baffled by poorer outcomes among African Americans. "Additional studies are required to elucidate the cause for the observed variation," Dr. Catalano commented.

In analyzing the data accumulated in the trial that included 713 Caucasians and 66 African Americans, Dr. Catalano and colleagues determined:

African Americans on average received fewer cycles of treatment -- nine cycles versus 7.4, a difference that was significant (P=0.03).

African Americans had a lower objective response rate -- 3% versus 12.5% (P=0.02).

African Americans had a non-significant shorter time of progression-free survival (P=0.08).

African Americans has a significantly shorter overall survival, 10.2 months versus 11.8 months (P=0.03) and this difference remained after adjustment for treatment, gender, age and performance status.

Toxicity was comparable between African Americans and Caucasians in the trial.

He said the results stand out because at the start of the trial there were no differences between Caucasians and African Americans "with regard to disease extent, performance status, gender, prior therapy and age distribution."

The average age of the participants was 60 for African Americans and 61 for Caucasians. Half the African American patients were men, and about 60% of the Caucasian participants were men.

In the E3200 study, the combination of FOLFOX plus bevacizumab significantly outperformed FOLFOX alone -- with patients not receiving the targeted vascular endothelial growth factor inhibitor being at a 26% greater risk of death and a 35% greater risk of disease progression.

FOLFOX, however, was superior to bevacizumab monotherapy.

Dr. Catalano disclosed no financial conflicts.

Primary source: American Society of Clinical Oncology Source reference: Catalano P et al , "Outcomes differences for African Americans and Caucasians treated with bevacizumab, FOLFOX4 or the combination in patients with metastatic colorectal cancer (MCRC):

Results from the Eastern Cooperative Oncology Group Study E3200" Abstract 4100.

Our source: www.medpagetoday.com


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