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1st-line Tx 60 yo w/ unresectable mets 1 y after adj FOLFOX? Pt age at which you don’t want to use bev?

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?

Bendell JC et al. Treatment patterns and clinical outcomes in patients with metastatic colorectal cancer initially treated with FOLFOX-bevacizumab or FOLFIRI-bevacizumab: Results from ARIES, a bevacizumab observational cohort study. Oncologist 2012;17(12):1486-95. Abstract

Fuchs CS et al. Randomized, controlled trial of irinotecan plus infusional, bolus, or oral fluoropyrimidines in first-line treatment of metastatic colorectal cancer: Updated results from the BICC-C study. J Clin Oncol 2008;26(4):689-90. Abstract

Giantonio BJ et al. Bevacizumab in combination with oxaliplatin, fluorouracil, and leucovorin (FOLFOX4) for previously treated metastatic colorectal cancer: Results from the Eastern Cooperative Oncology Group study E3200. J Clin Oncol 2007;25(12):1539-44. Abstract

Heinemann V et al. Randomized comparison of FOLFIRI plus cetuximab versus FOLFIRI plus bevacizumab as first-line treatment of KRAS wild-type metastatic colorectal cancer: German AIO study KRK-0306 (FIRE-3). Proc ASCO 2013;Abstract LBA3506.

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

Hurwitz H et al. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 2004;350(23):2335-42. Abstract

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.