Authors: Hajime Orita, Shoji Koshiba, Tomoyuki Kushida, Mutsumi Sakurada, Hiroshi Maekawa, Ryo Wada, Koichi Sato.
Background: Over the past decade, the outcome of treatment with chemotherapy for metastatic colorectal cancer (mCRC) is substantially better, with proven increases survival. However, many patients still suffer significant toxicities, such as peripheral neuropathy. In advanced countries, where most patients with mCRC are older, maintenance therapy is under study with the goal of reducing severe side effects and maintaining quality of life (QOL). Continuation of cytotoxic chemotherapy in the setting of accumulated toxicities is often not feasible, so less toxic drugs are needed over the long-term. Bevacizumab is one option that has low side effects and proven benefit when combined with chemotherapy. This report describes our experience in giving bevacizumab maintenance therapy to 11 older patients with mCRC and reviews maintenance therapy for mCRC.
Materials and Methods: Baseline clinical characteristics, pre-specified bevacizumab-related adverse events, and efficacy data were collected from the local patient registry. Approval was provided by the Juntendo University Hospital Institutional Review Board.
Results: Eleven patients received maintenance therapy after FOLFOX and/or FOLFIRI regimens for an average of 476 days. Maintenance therapy was instituted due to several side effects from oxaliplatin-based chemotherapy. Side effect included such as peripheral neuropathy and fatigue could reduce during maintenance therapy and get QOL until end stage.
Conclusions: Our experience with these 11 patients, demonstrates both prolonged survival as well as maintained QOL. Bevacizumab based maintenance therapy may be considered in elderly patients with mCRC.
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