What is your usual recommendation for first-line therapy for a 60-year-old patient who presents with widespread, unresectable metastases (PS = 0) 12 months after completion of adjuvant FOLFOX for Stage III KRAS wild-type (wt) colon cancer?
The patient had fared well on adjuvant FOLFOX except for minimal peripheral neuropathy that resolved in 6 months.
Is there a patient age at which you would not want to use bevacizumab?
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Hochster HS et al. Safety and efficacy of oxaliplatin and fluoropyrimidine regimens with or without bevacizumab as first-line treatment of metastatic colorectal cancer: Results of the TREE study. J Clin Oncol 2008;26(21):3523-9. Abstract
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Kabbinavar FF et al. Addition of bevacizumab to fluorouracil-based first-line treatment of metastatic colorectal cancer: Pooled analysis of cohorts of older patients from two randomized clinical trials. J Clin Oncol 2009;27(2):199-205. Abstract
Loupakis F et al. FOLFOXIRI plus bevacizumab (bev) versus FOLFIRI plus bev as first-line treatment of metastatic colorectal cancer (MCRC): Results of the phase III randomized TRIBE trial. Gastrointestinal Cancers Symposium 2013;Abstract 336.