Real-world utilization and acceptance of biosimilar bevacizumab in metastatic colorectal cancer in India
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20222629Keywords:
Bevacizumab, Biosimilar, Metastatic, Colorectal, CancerAbstract
Background: To describe the patient characteristics and usage pattern of biosimilar bevacizumab for the treatment of metastatic colorectal cancer (mCRC) in India.
Methods: This real-world, retrospective analysis included adult patients receiving biosimilar bevacizumab between April 2021 and March 2022.
Results: A total of 1125 patients with mCRC who received biosimilar bevacizumab-based chemotherapy were included. The mean age at diagnosis was 57.8 years. Majority of the patients were males (71%) and belonged to the age groups of 41-76 years. The primary tumor site was right colon (52.6%) followed by left colon (29.2%) and rectum (17.3%), and tumor grade was reported as high in most (88.7%) of the patients. Majority of the patients received biosimilar bevacizumab-based chemotherapy as first-line therapy (61.3%), followed by second-line (31.9%) and third-line therapy (6.8%). In combination with biosimilar bevacizumab, FOLFOX (folinic acid, 5-fluorouracil, and oxaliplatin) was the most commonly administered chemotherapy regimen (42.9%), followed by CAPOX (capecitabine and oxaliplatin, 26.5%) and FOLFIRI (folinic acid, 5-fluorouracil, and irinotecan, 22.8%).
Conclusions: Biosimilar bevacizumab-based chemotherapy is being widely used in real‑world clinical setting in India for the management of patients with mCRC.
Metrics
References
International Agency for Research on Cancer, World Health Organization. GLOBOCAN 2018: estimated cancer incidence, mortality and prevalence worldwide in 2018. World fact sheet. 2018. Available at: https://gco.iarc.fr/today/data/factsheets/populations/900-world-fact-sheets.pdf. Accessed on 26 May, 2022.
Brenner H, Kloor M, Pox CP. Colorectal cancer. Lancet (London, England). 2014;383:1490-502.
National Cancer Institute. SEER cancer statistics factsheets: colon and rectum cancer. 2016 Available at: http://seer.cancer.gov/statfacts/html/colorect.html. Accessed on 26 May, 2022.
Van Cutsem E, Cervantes A, Nordlinger B, Arnold D. Metastatic colorectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2014;25(3):1-9.
Van Cutsem E, Cervantes A, Adam R, Sobrero A, Van Krieken JH, Aderka D et al. ESMO consensus guidelines for the management of patients with metastatic colorectal cancer. Ann Oncol. 2016;27:1386-422.
Kasi PM, Hubbard JM, Grothey A. Selection of biologics for patients with metastatic colorectal cancer: the role of predictive markers. Expert rev Gastroenterol Hepatol. 2015;9:273-6.
Avastin (bevacizumab) summary of product characteristics. 2009. Available at: http://www.ema. europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000582/WC500029271.pdf. Accessed on 26 May, 2022.
Avastin (bevacizumab) prescribing information. 2004. Available at: https://www.accessdata.fda.gov/ drugsatfda_docs/label/2016/125085s317lbl.pdf. Accessed on 26 May, 2022.
Vaid AK, Mohapatra PN, Desai C. Indian consensus statement on the management of metastatic colorectal cancer. 2021;2021;8:9.
Patil PS, Saklani A, Gambhire P, Mehta S, Engineer R, De'Souza A et al. Colorectal Cancer in India: An Audit from a Tertiary Center in a Low Prevalence Area. Ind J Surg oncol. 2017;8:484-90.
Garcia J, Hurwitz HI, Sandler AB, Miles D, Coleman RL, Deurloo R et al. Bevacizumab (Avastin®) in cancer treatment: A review of 15 years of clinical experience and future outlook. Cancer Treat Rev. 2020;86:102017.
Hurwitz H, Fehrenbacher L, Novotny W, Cartwright T, Hainsworth J, Heim W et al. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Eng J Med. 2004;350:2335-42.
Bennouna J, Sastre J, Arnold D, Österlund P, Greil R, Van Cutsem E, et al. Continuation of bevacizumab after first progression in metastatic colorectal cancer (ML18147): a randomised phase 3 trial. Lancet Oncol. 2013;14:29-37.
Giantonio BJ, Catalano PJ, Meropol NJ, O'Dwyer PJ, Mitchell EP, Alberts SR 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;25:1539-44.
Saltz LB, Clarke S, Díaz-Rubio E, Scheithauer W, Figer A, Wong R, et al. Bevacizumab in Combination With Oxaliplatin-Based Chemotherapy As First-Line Therapy in Metastatic Colorectal Cancer: A Randomized Phase III Study. J Clin Oncol. 2008;26:2013-9.
Nakayama G, Ishigure K, Yokoyama H, Uehara K, Kojima H, Ishiyama A et al. The efficacy and safety of CapeOX plus bevacizumab therapy followed by capecitabine plus bevacizumab maintenance therapy in patients with metastatic colorectal cancer: a multi-center, single-arm, phase II study (CCOG-0902). BMC Cancer. 2017;17:243.
Petrelli F, Borgonovo K, Cabiddu M, Ghilardi M, Lonati V, Maspero F et al. FOLFIRI-bevacizumab as first-line chemotherapy in 3500 patients with advanced colorectal cancer: a pooled analysis of 29 published trials. Clin Colorectal Cancer. 2013;12:145-51.
Norbeck TB. Drivers of health care costs. A Physicians Foundation white paper - second of a three-part series. Missouri Med. 2013;110:113-8.
Dinesh TA, Nair P, Abhijath V, Jha V, Aarthy K. Economics of cancer care: A community-based cross-sectional study in Kerala, India. S Asian J Cancer. 2020;9:7-12.
Cortes J, Perez-García JM, Llombart-Cussac A, Curigliano G, El Saghir NS, Cardoso F et al. Enhancing global access to cancer medicines. CA Cancer J Clin. 2020;70:105-24.
Dolan C. Opportunities and challenges in biosimilar uptake in oncology. Am J Managed Care. 2018;24:S237-43.
Lyman GH, Zon R, Harvey RD, Schilsky RL. Rationale, Opportunities, and Reality of Biosimilar Medications. N Eng J Med. 2018;378:2036-44.
Cohen H, Beydoun D, Chien D, Lessor T, McCabe D, Muenzberg M et al. Awareness, Knowledge, and Perceptions of Biosimilars Among Specialty Physicians. Adv Therapy. 2017;33:2160-72.
