DOI: https://dx.doi.org/10.18203/2319-2003.ijbcp20222629
Published: 2022-10-27

Real-world utilization and acceptance of biosimilar bevacizumab in metastatic colorectal cancer in India

Deepak Bunger, Anil Rajani, Lav Patel, Shreekant Sharma

Abstract


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.


Keywords


Bevacizumab, Biosimilar, Metastatic, Colorectal, Cancer

Full Text:

PDF

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.