FOLFIRI plus BEvacizumab or aFLIbercept after FOLFOX-bevacizumab Failure for COlorectal Cancer (BEFLICO): An AGEO Multicenter Study.

Cécile Torregrosa (1) , Simon Pernot (2) , Pauline Vaflard (3) , Audrey Perret (4) , Christophe Tournigand (5) , Violaine Randrian (6) , Solene Doat (7) , Cindy Neuzillet (3) , Valérie Moulin (8) , Morgane Stouvenot , Gael Roth (9, 10) , Tiffany Darbas (11) , Benjamin Auberger , Tiphaine Godet , Marion Jaffrelot , Aurélien Lambert (12) , Olivier Dubreuil (13) , Cassandre Gluszak , Alice Bernard-Tessier (3) , Anthony Turpin (14, 15) , Lola-Jade Palmieri (7, 16) , Olivier Bouche (17, 18) , Gael Goujon (19) , Thierry Lecomte (20, 21, 22) , David Sefrioui (23) , Christophe Locher (24) , Lucien Grados (25) , Pauline Gignoux , Stéphanie Trager , Elise Nassif (26) , Angélique Saint (27) , Pascal Hammel (28) , Cédric Lecaille (29) , Mathilde Bureau (30) , Marine Perrier (31, 16) , Damien Botsen (17, 18, 32) , Vincent Bourgeois (33) , Julien Taieb (34, 35, 26) , Edouard Auclin (35)

1 LRSV - Laboratoire de Recherche en Sciences Végétales
2 Institut Bergonié [Bordeaux]
3 Institut Curie [Paris]
4 EthoS - Ethologie animale et humaine
5 IMRB - Institut Mondor de Recherche Biomédicale
6 CHU Poitiers - Centre hospitalier universitaire de Poitiers
7 Service d'Hépato-Gastro-Entérologie [CHU Pitié-Salpêtrière]
8 Groupe hospitalier de La Rochelle
9 CHU - Centre Hospitalier Universitaire [Grenoble]
10 UGA - Université Grenoble Alpes
11 CHU Limoges
12 UNICANCER/ICL - Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy]
13 CEA-LETI - Commissariat à l'énergie atomique et aux énergies alternatives - Laboratoire d'Electronique et de Technologie de l'Information
14 CHRU Lille - Centre Hospitalier Régional Universitaire [Lille]
15 CANTHER - Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277
16 SU FM - Sorbonne Université - Faculté de Médecine
17 URCA - Université de Reims Champagne-Ardenne
18 CHU Reims - Centre Hospitalier Universitaire de Reims
19 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
20 N2C - Nutrition, croissance et cancer (U 1069)
21 GICC EA 7501 - Groupe innovation et ciblage cellulaire (GICC), EA 7501 [2018-...]
22 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
23 CCD - Communications Cellulaires et Différenciation
24 Centre Hospitalier de Meaux
25 PERITOX - Périnatalité et Risques Toxiques - UMR INERIS_I 1
26 HEGP - Hôpital Européen Georges Pompidou [APHP]
27 UNICANCER/CAL - Centre de Lutte contre le Cancer Antoine Lacassagne [Nice]
28 Hôpital Paul Brousse
29 Polyclinique Bordeaux Nord Aquitaine
30 BPH - Bordeaux population health
31 Laboratoire de Virologie [CHU Saint-Antoine]
32 Institut Jean Godinot [Reims]
33 Centre Hospitalier Boulogne-sur-mer
34 Cancer Research and Personalized Medicine - CARPEM [Paris]
35 CRC (UMR_S_1138 / U1138) - Centre de Recherche des Cordeliers

After failure of first line FOLFOX-bevacizumab for metastatic colorectal cancer (mCRC), adding either bevacizumab or aflibercept to second-line FOLFIRI increases survival compared to FOLFIRI alone. In this French retrospective multicentre cohort, we included patients with a mCRC treated with either FOLFIRI-aflibercept or FOLFIRI-bevacizumab. The primary endpoint was overall survival (OS), and secondary endpoints were progression-free survival (PFS), disease control rate (DCR: CR\,+\,PR\,+\,SD) and safety. We included 681 patients from 36 centers, 326 and 355 in the aflibercept and bevacizumab groups, respectively. Median age was 64.2\,years and 45.2% of patients were men. Most patients had RAS-mutated tumors (80.8%) and synchronous metastases (85.7%). After a median follow up of 31.2~months, median OS was 13.0~months (95% CI: 11.3-14.7) and 10.4~months (95% CI: 8.8-11.4) in the bevacizumab and aflibercept groups, respectively (P\,<\,.0001). Median PFS was 6.0~months (95% CI: 5.4-6.5) and 5.1~months (95% CI: 4.3-5.6) (P\,<\,.0001). After adjustment on age, PS, PFS of first line, primary tumor resection, metastasis location and RAS/BRAF status, bevacizumab was still associated with better OS (HR: 0.71, 95% CI: 0.59-0.86, P~=~.0003). FOLFIRI-bevacizumab combination was associated with longer OS and PFS, and a better tolerability, as compared to FOLFIRI-aflibercept after progression on FOLFOX-bevacizumab.

Domaines: Sciences du Vivant [q-bio]; Médecine humaine et pathologie

Cécile Torregrosa, Simon Pernot, Pauline Vaflard, Audrey Perret, Christophe Tournigand, et al.. FOLFIRI plus BEvacizumab or aFLIbercept after FOLFOX-bevacizumab Failure for COlorectal Cancer (BEFLICO): An AGEO Multicenter Study.. International Journal of Cancer, 2022, ⟨10.1002/ijc.34166⟩. ⟨hal-03735625⟩