Abstract Types

Clinical Review Abstract

Late-Breaking Abstract

Trials in Progress Abstract

Abstracts selected for publication but not presentation at the Annual Meeting

Abstracts granted an exception in accordance with ASCO's Conflict of Interest Policy

Use of biologics in addition to chemotherapy in the treatment of elderly Medicare patients with stage IV metastatic colon cancer.

Colorectal Cancer

Gastrointestinal (Colorectal) Cancer

2013 ASCO Annual Meeting

Abstract No:

J Clin Oncol 31, 2013 (suppl; abstr e14602)

Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2013 Annual Meeting but not presented at the Meeting, can be found online only.

Author(s): C. Daniel Mullins, Fenghao Wang, Kaloyan A. Bikov, Brian S. Seal, Nader Hanna; University of Maryland School of Pharmacy, Baltimore, MD; School of Pharmacy, University of Maryland, Baltimore, MD; Bayer HealthCare Pharmaceuticals, Wayne, NJ; University of Maryland, Department of Surgery, Division of General and Oncologic Surgery, Baltimore, MD

Abstract Disclosures


Background: On February 12 and 26, 2004, the FDA approved bevacizumab and cetuximab, respectively, two biologic drugs for the first–line treatment of metastatic colorectal cancer (mCC), followed by panitumumab, another biologic approved on September 27, 2006. NCCN guidelines suggest that biologics may be added to fluorouracil and leucovorin (5-FU/LV), irinotecan (IRI), or oxaliplatin (OX), yet a number of recent articles raise questions regarding the added benefit of biologics on top of a backbone chemotherapy regimen, which might affect the utilization pattern of biologics. To examine the adoption of biologics, we document the rate of treatment with biologics in addition to backbone chemotherapy as first-line treatment (Tx1) of mCC. Methods: This study uses the Surveillance, Epidemiology and End Results (SEER)-Medicare data and examines mCC patients diagnosed in 2003-2007 who received chemotherapy with or without biologics as Tx1. Due to the small sample size of cases involving the combined use of irinotecan and oxaliplatin (IROX) as Tx1, IROX patients were excluded from this study. The remaining 2995 observations are broken down by regimen and by year of Tx1 initiation (Table). Results: The use of biologics (90% of which was bevacizumab) in addition to chemotherapy as part of Tx1 exploded from 9% in 2004 to 55% in 2005. Utilization was highest (62%) in 2006 and fell slightly in 2007 to 57%. Of all cases utilizing biologics, 67% were oxaliplatin-based regimens, 19% were fluorouracil-based regimens and 15% were irinotecan-based regimens. Conclusions: In the first few years following FDA approval, the use of biologics in addition to backbone chemotherapy increased rapidly as first-line treatment of elderly Medicare metastatic colon cancer patients, leveling out at around half of all patients receiving chemotherapy. Biologics use has been most common among patients treated with oxaliplatin.

Yearly treatments by regimens.
2003 2004 2005 2006 2007 Total
5FU/LV 284 225 137 99 109 854
5FU/LV+Biologics 0 14 77 62 58 211
IRI 176 109 30 17 17 349
IRI+Biologics 0 16 59 39 50 164
OX 34 260 129 112 134 669
OX+Biologics 0 32 221 265 230 748
Total 494 656 653 594 598 2995


  Other Abstracts in this Sub-Category:


1. Effect of 3-5 years of scheduled CEA and CT follow-up to detect recurrence of colorectal cancer: FACS randomized controlled trial.

Meeting: 2013 ASCO Annual Meeting Abstract No: 3500 First Author: D. Mant
Category: Gastrointestinal (Colorectal) Cancer - Colorectal Cancer


2. Phase III randomized, placebo (PL)-controlled, double-blind study of intravenous calcium/magnesium (CaMg) to prevent oxaliplatin-induced sensory neurotoxicity (sNT), N08CB: An alliance for clinical trials in oncology study.

Meeting: 2013 ASCO Annual Meeting Abstract No: 3501 First Author: C. L. Loprinzi
Category: Gastrointestinal (Colorectal) Cancer - Colorectal Cancer


3. Maintenance treatment with capecitabine and bevacizumab versus observation after induction treatment with chemotherapy and bevacizumab in metastatic colorectal cancer (mCRC): The phase III CAIRO3 study of the Dutch Colorectal Cancer Group (DCCG).

Meeting: 2013 ASCO Annual Meeting Abstract No: 3502 First Author: M. Koopman
Category: Gastrointestinal (Colorectal) Cancer - Colorectal Cancer