Colorectal Cancer
Conditions
Brief summary
This multicenter, prospective, observational study will evaluate the efficacy and safety of Avastin (bevacizumab) in first-line therapy in elderly patients with metastatic colorectal cancer. Data will be collected from eligible patients for24 months.
Interventions
None listed
Sponsors
Study design
Eligibility
Inclusion criteria
* Adult patients, \>/= 75 years of age * Metastatic colorectal cancer * Initiating Avastin first-line therapy in combination with chemotherapy
Exclusion criteria
* Previous Avastin therapy * Patient participating in a clinical study evaluating a cytotoxic anti-cancer therapy and/or an investigational new drug
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Progression-Free Survival | From the time of first dose of study treatment to the time of disease progression or death from any cause (Up to 53 months) | Progression was defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Bevacizumab Administration | Up to 36 months | — |
| Percentage of Participants With Adverse Events (AEs) | Up to 53 months | An AE was considered any unfavorable and unintended sign, symptom, or disease associated with the use of the study drug, whether or not considered related to the study drug. |
| Overall Survival | From the time of first dose of study treatment to the time of death from any cause (Up to 53 months) | Overall survival was defined as the time between the treatment start date (date of the first infusion of bevacizumab) and date of all-cause death. |
| Lawton Instrumental Activities of Daily Living Score (IADL) | Baseline, Month 6, 12, 24 | The Lawton Instrumental Activities of Daily Living Scale (IADL) is an appropriate instrument to assess independent living skills. The instrument is most useful for identifying how a participant is functioning at the present time and for identifying improvement or deterioration over time. There are 8 domains of function measured with the Lawton IADL scale (telephone use, shopping, cooking, housekeeping, laundry, mode of transportation, responsibility of own medications, and ability to handle finances). Participants are scored according to their level of functioning from 0 (low function, dependent) to 8 (high function, independent). Higher score for each domain represents better functional performance of the older people. |
| Percentage of Participants With Balducci Score | Baseline, Month 6, 12, 24 | Balducci score defines an algorithm for the individual participant according to age, ADL and modified IADL 4-items scores, estimated performance status and comorbidities, particularly cardiovascular, cancer, depression or anemia. Balducci score is categorized in the following- Type 1 (Harmonious), Type 2 (Intermediate) and Type 3 (Frail). Type 1 indicates better results and Type 3 indicates worse outcomes. |
| Percentage of Participants With Activities of Daily Living (ADL) | Baseline, Month 6, 12, 24 | The Katz Activity of Daily Living (ADL) questionnaire scale contains 6 items evaluating in terms of autonomy or dependence the patient's ability to carry out basic activities of daily living (bathing, dressing, toileting, transfer, continence, feeding). Total score range 0 (low) to 6 (high). High score indicates participant is independent. |
Countries
France
Participant flow
Recruitment details
A total of 402 participants were enrolled from 100 French sites.
Pre-assignment details
The data in the study for participant flow, baseline characteristics, outcome measure and adverse events was collected for overall participants and not as per the dose administered to participants.
Participants by arm
| Arm | Count |
|---|---|
| Bevacizumab Participants received initial dose of either 5 milligram per kilogram (mg/kg) every 2 weeks or 7.5 mg/kg every 3 weeks of bevacizumab irrespective of the age subgroup. | 358 |
| Total | 358 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | 75 years old or more ticked No | 1 |
| Overall Study | Death linked to an adverse event | 14 |
| Overall Study | Death linked to progression of disease | 165 |
| Overall Study | Investigator's decision | 10 |
| Overall Study | Lost follow-up/moved house/changed team | 35 |
| Overall Study | Missing data | 1 |
| Overall Study | Missing start date of infusion | 8 |
| Overall Study | No information on Bevacizumab intake | 11 |
| Overall Study | Participant not wishing to continue | 5 |
| Overall Study | Treatment with Bevacizumab ticked No | 24 |
Baseline characteristics
| Characteristic | Bevacizumab |
|---|---|
| Age, Continuous | 80.5 Years STANDARD_DEVIATION 3.8 |
| Sex: Female, Male Female | 173 Participants |
| Sex: Female, Male Male | 185 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 169 / 383 |
| serious Total, serious adverse events | 98 / 383 |
Outcome results
Progression-Free Survival
Progression was defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
Time frame: From the time of first dose of study treatment to the time of disease progression or death from any cause (Up to 53 months)
Population: The efficacy population (EFF) included all participants who had at least one infusion of bevacizumab, without exclusion criteria and excluding participants with no intake of chemotherapy, or intake of bevacizumab before or 2 months after chemotherapy initiation. Data in study was collected for overall participants and not as per dose administered.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Bevacizumab | Progression-Free Survival | 9.14 Months |
Lawton Instrumental Activities of Daily Living Score (IADL)
The Lawton Instrumental Activities of Daily Living Scale (IADL) is an appropriate instrument to assess independent living skills. The instrument is most useful for identifying how a participant is functioning at the present time and for identifying improvement or deterioration over time. There are 8 domains of function measured with the Lawton IADL scale (telephone use, shopping, cooking, housekeeping, laundry, mode of transportation, responsibility of own medications, and ability to handle finances). Participants are scored according to their level of functioning from 0 (low function, dependent) to 8 (high function, independent). Higher score for each domain represents better functional performance of the older people.
Time frame: Baseline, Month 6, 12, 24
Population: The EFF included all participants who had at least one infusion of bevacizumab, without exclusion criteria and excluding participants with no intake of chemotherapy, or intake of bevacizumab before or 2 months after chemotherapy initiation. Data in the study was collected for overall participants and not as per dose administered to participants.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Bevacizumab | Lawton Instrumental Activities of Daily Living Score (IADL) | Baseline | 0.9 units on a scale | Standard Deviation 1.1 |
| Bevacizumab | Lawton Instrumental Activities of Daily Living Score (IADL) | Month 6 | 1.0 units on a scale | Standard Deviation 1.2 |
| Bevacizumab | Lawton Instrumental Activities of Daily Living Score (IADL) | Month 12 | 1.0 units on a scale | Standard Deviation 1.2 |
| Bevacizumab | Lawton Instrumental Activities of Daily Living Score (IADL) | Month 24 | 0.8 units on a scale | Standard Deviation 1.2 |
Overall Survival
Overall survival was defined as the time between the treatment start date (date of the first infusion of bevacizumab) and date of all-cause death.
Time frame: From the time of first dose of study treatment to the time of death from any cause (Up to 53 months)
Population: The EFF included all participants who had at least one infusion of bevacizumab, without exclusion criteria and excluding participants with no intake of chemotherapy, or intake of bevacizumab before or 2 months after chemotherapy initiation. Data in the study was collected for overall participants and not as per dose administered to participants.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Bevacizumab | Overall Survival | 19.00 Months |
Percentage of Participants With Activities of Daily Living (ADL)
The Katz Activity of Daily Living (ADL) questionnaire scale contains 6 items evaluating in terms of autonomy or dependence the patient's ability to carry out basic activities of daily living (bathing, dressing, toileting, transfer, continence, feeding). Total score range 0 (low) to 6 (high). High score indicates participant is independent.
Time frame: Baseline, Month 6, 12, 24
Population: The EFF included all participants who had at least one infusion of bevacizumab, without exclusion criteria and excluding participants with no intake of chemotherapy, or intake of bevacizumab before or 2 months after chemotherapy initiation. Data in the study was collected for overall participants and not as per dose administered to participants.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Baseline: Dressing (self-sufficient) | 92.9 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Baseline: Feeding (needs help) | 3.4 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 6: Bathing (self-sufficient) | 85.4 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 6: Bathing (partial help) | 13.1 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 24: Feeding (self-sufficient) | 91.3 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Baseline: Bathing (self-sufficient) | 89.2 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Baseline: Bathing (partial help) | 8.2 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Baseline: Bathing (washing impossible) | 2.5 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Baseline: Dressing (partial help) | 4.2 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Baseline: Dressing (completely undressed) | 2.8 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Baseline: Toileting (self-sufficient) | 95.8 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Baseline: Toileting (needs help) | 2.5 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Baseline: Toileting (doesn't go) | 1.7 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Baseline: Transfer (self-sufficient) | 90.7 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Baseline: Transfer (needs help) | 8.2 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Baseline: Transfer (bedridden) | 1.1 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Baseline: Cont (continent) | 86.6 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Baseline:Cont (occasional incontinence) | 12.3 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Baseline:Cont (permanent incontinence) | 1.1 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Baseline: Feeding (self-sufficient) | 96.6 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 6: Bathing (washing impossible) | 1.5 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 6: Dressing (self-sufficient) | 91.9 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 6: Dressing (partial help) | 6.5 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 6: Dressing (completely undressed) | 1.5 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 6: Toileting (self-sufficient) | 95.0 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 6: Toileting (needs help) | 4.6 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 6: Toileting (doesn't go) | 0.4 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 6: Transfer (self-sufficient) | 91.2 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 6: Transfer (needs help) | 8.8 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 6: Cont (continent) | 89.6 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 6: Cont (occasional incontinence) | 10.0 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 6: Cont (permanent incontinence) | 0.4 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 6: Feeding (self-sufficient) | 94.6 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 6: Feeding (needs help) | 5.4 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 12: Bathing (self-sufficient) | 83.1 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 12: Bathing (partial help) | 11.4 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 12: Bathing (washing impossible) | 5.5 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 12: Dressing (self-sufficient) | 88 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 12: Dressing (partial help) | 7.0 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 12: Dressing (completely undressed) | 5.0 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 12: Toileting (self-sufficient) | 91.5 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 12: Toileting (needs help) | 6.5 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 12: Toileting (doesn't go) | 2.0 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 12: Transfer (self-sufficient) | 85.1 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 12: Transfer (needs help) | 11.9 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 12: Transfer (bedridden) | 3.0 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 12: Cont (continent) | 89.3 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 12: Cont (occasional incontinence) | 9.1 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 12: Cont (permanent incontinence) | 1.5 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 12: Feeding (self-sufficient) | 91.4 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 12: Feeding (needs help) | 7.1 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 12: Feeding (complete help) | 1.5 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 24: Bathing (self-sufficient) | 89.4 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 24: Bathing (partial help) | 6.7 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 24: Bathing (washing impossible) | 3.8 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 24: Dressing (self-sufficient) | 91.3 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 24: Dressing (partial help) | 3.8 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 24: Dressing (completely undressed) | 4.8 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 24: Toileting (self-sufficient) | 93.3 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 24: Toileting (needs help) | 6.7 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 24: Transfer (self-sufficient) | 86.5 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 24: Transfer (needs help) | 13.5 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 24: Cont (continent) | 90.4 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 24: Cont (occasional incontinence) | 9.6 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 24: Feeding (needs help) | 6.7 Percentage of participants |
| Bevacizumab | Percentage of Participants With Activities of Daily Living (ADL) | Month 24: Feeding (complete help) | 1.9 Percentage of participants |
Percentage of Participants With Adverse Events (AEs)
An AE was considered any unfavorable and unintended sign, symptom, or disease associated with the use of the study drug, whether or not considered related to the study drug.
Time frame: Up to 53 months
Population: Safety population included all participants who had at least one infusion of bevacizumab. Data in the study was collected for overall participants and not as per dose administered to participants.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Bevacizumab | Percentage of Participants With Adverse Events (AEs) | 60.8 Percentage of participants |
Percentage of Participants With Balducci Score
Balducci score defines an algorithm for the individual participant according to age, ADL and modified IADL 4-items scores, estimated performance status and comorbidities, particularly cardiovascular, cancer, depression or anemia. Balducci score is categorized in the following- Type 1 (Harmonious), Type 2 (Intermediate) and Type 3 (Frail). Type 1 indicates better results and Type 3 indicates worse outcomes.
Time frame: Baseline, Month 6, 12, 24
Population: The EFF included all participants who had at least one infusion of bevacizumab, without exclusion criteria and excluding participants with no intake of chemotherapy, or intake of bevacizumab before or 2 months after chemotherapy initiation. Data in the study was collected for overall participants and not as per dose administered to participants.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Bevacizumab | Percentage of Participants With Balducci Score | Month 12: Don't know | 33.0 Percentage of participants |
| Bevacizumab | Percentage of Participants With Balducci Score | Month 12: Type 1 (Harmonious) | 39.8 Percentage of participants |
| Bevacizumab | Percentage of Participants With Balducci Score | Month 12: Type 2 (Intermediate) | 19.4 Percentage of participants |
| Bevacizumab | Percentage of Participants With Balducci Score | Month 12: Type 3 (Frail) | 7.8 Percentage of participants |
| Bevacizumab | Percentage of Participants With Balducci Score | Month 24: Don't know | 27.3 Percentage of participants |
| Bevacizumab | Percentage of Participants With Balducci Score | Month 24: Type 1 (Harmonious) | 50.5 Percentage of participants |
| Bevacizumab | Percentage of Participants With Balducci Score | Month 24: Type 2 (Intermediate) | 16.2 Percentage of participants |
| Bevacizumab | Percentage of Participants With Balducci Score | Month 24: Type 3 (Frail) | 6.1 Percentage of participants |
| Bevacizumab | Percentage of Participants With Balducci Score | Baseline: Don't know | 36.8 Percentage of participants |
| Bevacizumab | Percentage of Participants With Balducci Score | Baseline: Type 1 (Harmonious) | 38.8 Percentage of participants |
| Bevacizumab | Percentage of Participants With Balducci Score | Baseline: Type 2 (Intermediate) | 21.1 Percentage of participants |
| Bevacizumab | Percentage of Participants With Balducci Score | Baseline: Type 3 (Frail) | 3.4 Percentage of participants |
| Bevacizumab | Percentage of Participants With Balducci Score | Month 6: Don't know | 37.3 Percentage of participants |
| Bevacizumab | Percentage of Participants With Balducci Score | Month 6: Type 1 (Harmonious) | 36.9 Percentage of participants |
| Bevacizumab | Percentage of Participants With Balducci Score | Month 6: Type 2 (Intermediate) | 22.3 Percentage of participants |
| Bevacizumab | Percentage of Participants With Balducci Score | Month 6: Type 3 (Frail) | 3.5 Percentage of participants |
Percentage of Participants With Bevacizumab Administration
Time frame: Up to 36 months
Population: The EFF included all participants who had at least one infusion of bevacizumab, without exclusion criteria and excluding participants with no intake of chemotherapy, or intake of bevacizumab before or 2 months after chemotherapy initiation.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Bevacizumab | Percentage of Participants With Bevacizumab Administration | 5 mg/kg/2 weeks | 90.8 Percentage of participants |
| Bevacizumab | Percentage of Participants With Bevacizumab Administration | 7.5 mg/kg/3 weeks | 7.3 Percentage of participants |
| Bevacizumab | Percentage of Participants With Bevacizumab Administration | At least one change in dosing | 1.7 Percentage of participants |
| Bevacizumab | Percentage of Participants With Bevacizumab Administration | At least one temporary discontinuation | 12.3 Percentage of participants |
| Bevacizumab | Percentage of Participants With Bevacizumab Administration | Permanent discontinuation | 82.4 Percentage of participants |