Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr 24;14(9):2118.
doi: 10.3390/cancers14092118.

Comparative Effectiveness of Bevacizumab versus Cetuximab in Metastatic Colorectal Cancer Patients without Primary Tumor Resection

Yi-Chia Su  1   2   3 , Chih-Chien Wu  4   5 , Chien-Chou Su  6   7 , Meng-Che Hsieh  8   9 , Ching-Lan Cheng  2   7 , Yea-Huei Kao Yang  2   10
Affiliations

Comparative Effectiveness of Bevacizumab versus Cetuximab in Metastatic Colorectal Cancer Patients without Primary Tumor Resection

Yi-Chia Su et al. Cancers (Basel). .

Abstract

Primary tumor resection may be unfeasible in metastatic colorectal cancer. We determined the effects of bevacizumab and cetuximab therapies on survival or conversion surgery in patients with metastatic colorectal cancer who did not undergo primary tumor resection. This retrospective cohort study enrolled 8466 patients who underwent first-line bevacizumab- or cetuximab-based therapy. We analyzed the data of both therapies in patients who did not undergo primary tumor resection. Overall survival after targeted therapy plus chemotherapy was assessed. The groups were matched using propensity score matching and weighting. Cetuximab resulted in lower mortality than bevacizumab (hazard ratio (HR) = 0.75); however, it did not have the same effect in patients that underwent primary tumor resection (HR = 0.95) after propensity score weighting. Among patients treated with targeted agents, primary tumor resection was associated with lower mortality among those who received both bevacizumab (HR = 0.60) and cetuximab (HR = 0.75). Among patients that did not undergo primary tumor resection, multivariable analysis for conversion surgery showed that the cetuximab group (HR = 1.82) had a significantly higher metastasectomy rate. In these patients, cetuximab-based therapy was associated with significantly better survival compared with bevacizumab-based therapy. Cetuximab also yielded a higher conversion surgery rate. These findings demonstrate the importance of stratification by primary tumor resection in the application of current treatment guidelines and initiation of future clinical trials.

Keywords: bevacizumab; cetuximab; metastatic colorectal cancer; primary tumor resection.

PubMed Disclaimer

Conflict of interest statement

The funding source was involved in the collection and management of the data. The funding source had no role in the design and conduct of the study; analysis and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of cohort selection. mCRC, metastatic colorectal cancer.
Figure 2
Figure 2
Kaplan–Meier survival curves for OS in mCRC in (a) patients without primary tumor resection (b) the overall population. mCRC, metastatic colorectal cancer; OS, overall survival.
Figure 2
Figure 2
Kaplan–Meier survival curves for OS in mCRC in (a) patients without primary tumor resection (b) the overall population. mCRC, metastatic colorectal cancer; OS, overall survival.
Figure 3
Figure 3
HRs of OS and conversion surgery among patients who did not undergo PTR and in the overall population; bevacizumab versus cetuximab. CI, confidence interval; HR, hazard ratio; OS, overall survival; PS, propensity score; PTR, primary tumor resection; SIPTW, stabilized inverse probability of treatment weights.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Bray F., Ferlay J., Soerjomataram I., Siegel R.L., Torre L.A., Jemal A. Global Cancer statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J. Clin. 2018;68:394–424. doi: 10.3322/caac.21492. - DOI - PubMed
    1. Vatandoust S., Price T.J., Karapetis C.S. Colorectal Cancer: Metastases to a Single Organ. World J. Gastroenterol. 2015;21:11767–11776. doi: 10.3748/wjg.v21.i41.11767. - DOI - PMC - PubMed
    1. Botrel T.E.A., Clark L.G.O., Paladini L., Clark O.A.C. Efficacy and Safety of Bevacizumab plus Chemotherapy Compared to Chemotherapy Alone in Previously Untreated Advanced or Metastatic Colorectal Cancer: A Systematic Review and Meta-Analysis. BMC Cancer. 2016;16:677. doi: 10.1186/s12885-016-2734-y. - DOI - PMC - PubMed
    1. Wu C.C., Wang J.H., Lin P.C., Liang C.A., Huang C.Y., Lien H.C., Chen C.Y., Chou K.J., Su Y.C. Tumor Sidedness and Efficacy of First-Line Therapy in Patients with RAS/BRAF Wild-Type Metastatic Colorectal Cancer: A Network Meta-Analysis. Crit. Rev. Oncol. Hematol. 2020;145:102823. doi: 10.1016/j.critrevonc.2019.102823. - DOI - PubMed
    1. Kemeny N. Management of Liver Metastases from Colorectal Cancer. Oncology. 2006;20:1161–1176. - PubMed

LinkOut - more resources