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 (9) , Gael Roth (10, 11) , Tiffany Darbas (12) , Benjamin Auberger (13) , Tiphaine Godet (14) , Marion Jaffrelot (15) , Aurélien Lambert (16) , Olivier Dubreuil (17) , Cassandre Gluszak (18) , Alice Bernard-Tessier (3) , Anthony Turpin (19, 20) , Lola-Jade Palmieri (7, 21) , Olivier Bouche (22, 23) , Gael Goujon (24) , Thierry Lecomte (25, 26, 27) , David Sefrioui (28) , Christophe Locher (29) , Lucien Grados (30) , Pauline Gignoux (31) , Stéphanie Trager (32) , Elise Nassif (33) , Angélique Saint (34) , Pascal Hammel (35) , Cédric Lecaille (36) , Mathilde Bureau (37) , Marine Perrier (38, 21) , Damien Botsen (22, 23, 39) , Vincent Bourgeois (40) , Julien Taieb (41, 42, 33) , Edouard Auclin (42)

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 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
10 CHU - Centre Hospitalier Universitaire [Grenoble]
11 UGA - Université Grenoble Alpes
12 CHU Limoges
13 CHU - BREST - Hopital de Bohars - CHRU Brest
14 CHU Angers - Centre Hospitalier Universitaire d'Angers
15 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
16 UNICANCER/ICL - Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy]
17 CEA-LETI - Commissariat à l'énergie atomique et aux énergies alternatives - Laboratoire d'Electronique et de Technologie de l'Information
18 UNICANCER/ICO - Institut de Cancérologie de l'Ouest [Angers/Nantes]
19 CHRU Lille - Centre Hospitalier Régional Universitaire [Lille]
20 CANTHER - Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277
21 SU FM - Sorbonne Université - Faculté de Médecine
22 URCA - Université de Reims Champagne-Ardenne
23 CHU Reims - Centre Hospitalier Universitaire de Reims
24 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
25 N2C - Nutrition, croissance et cancer (U 1069)
26 GICC EA 7501 - Groupe innovation et ciblage cellulaire (GICC), EA 7501 [2018-...]
27 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
28 CCD - Communications Cellulaires et Différenciation
29 Centre Hospitalier de Meaux
30 PERITOX - Périnatalité et Risques Toxiques - UMR INERIS_I 1
31 Hôpital Louis Domergue [CHU de la Martinique]
32 Clinique de l'Estrée
33 HEGP - Hôpital Européen Georges Pompidou [APHP]
34 UNICANCER/CAL - Centre de Lutte contre le Cancer Antoine Lacassagne [Nice]
35 Hôpital Paul Brousse
36 PBNA - Polyclinique Bordeaux Nord Aquitaine
37 BPH - Bordeaux population health
38 Laboratoire de Virologie [CHU Saint-Antoine]
39 Institut Jean Godinot [Reims]
40 Centre Hospitalier Boulogne-sur-mer
41 Cancer Research and Personalized Medicine - CARPEM [Paris]
42 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: 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⟩