PB1442 - Bevacizumab and the risk of venous and arterial thromboembolism in patients with recurrent/metastatic colorectal cancer: A Korean population-based study

Tuesday, June 25, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

HY

Ho-Young Yhim, MD, PhD

Clinician-Scientist
Jeonbuk National University Medical School
Jeonju, Cholla-bukto, Republic of Korea

Co-Author(s)

JL

Ju-Hyun Lee

MS
Seoul National University Bundang Hospital
Seongnam, Kyonggi-do, Republic of Korea
KK

Kyoung Ha Kim

MD, PhD
Soonchunhyang University College of Medicine
Seoul, Seoul-t'ukpyolsi, Republic of Korea
Sang-A Kim, MD

Assistant professor
Seoul National University Bundang Hospital
Seongnam, Kyonggi-do, Republic of Korea
Ji Yun Lee, PhD, MD

associated professor
Seoul National University Bundang Hospital
Seongnam, Kyonggi-do, Republic of Korea
HH

Hun-Gyu Hwang

MD, PhD
Department of Internal Medicine, Gumi Hospital, Soonchunhyang University College of Medicine
Gumi, Kyongsang-bukto, Republic of Korea
JH

Junshik Hong

M.D., Ph.D.
3) Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea
JL

Jeong-Ok Lee

MD, PhD
Seoul National University Hospital, Seoul National University College of Medicine
Seongnam, Kyonggi-do, Republic of Korea
Soo-Mee Bang, MD, PhD

Seoul National University Bundang Hospital, Seoul National University College of Medicine
Seongnam, Kyonggi-do, Republic of Korea

Background: Large-scale epidemiological data are lacking to determine the risk of adverse outcomes, including venous and arterial thromboembolism (VTE and ATE), bleeding, congestive heart failure (CHF), and gastrointestinal (GI) perforation in Asian cancer patients treated with bevacizumab and chemotherapy.

Aims: This population-based study aimed to assess the risk of VTE, ATE, hospitalization for major bleeding, hospitalization for CHF, new hypertension treatment, and hospitalization for GI perforation in recurrent/metastatic colorectal cancer patients treated with bevacizumab-containing chemotherapy.

Methods: Data from the Health Insurance Review and Assessment Service database of South Korea for recurrent/metastatic colorectal cancer patients (July 2013 and June 2020) were analyzed. Patients received first-line oxaliplatin- or irinotecan-based chemotherapy, alone or with bevacizumab, without secondary prevention for VTE and ATE.

Results: Among 24,568 patients, 12,475 patients received bevacizumab plus chemotherapy (irinotecan [n=6,712] or oxaliplatin [n=5,763] plus fluoropyrimidine), and 12,093 had chemotherapy alone (irinotecan [n=5,599] or oxaliplatin [n=6,494] plus fluoropyrimidine). Patients with bevacizumab were older, had more comorbidities, recent surgery, and colon cancer (Table 1).
Patients with bevacizumab plus chemotherapy had a significantly higher risk of VTE (HR 1.14, 95% CI 1.01-1.30; Figure 1A), hospitalization for CHF (HR 1.46, 95% CI 1.25-1.71), new hypertension treatment (HR 1.55, 95% CI 1.41-1.71) and hospitalization of GI perforation (HR 1.79, 95% CI 1.37-2.35) compared to those with chemotherapy alone. However, the risk of ATE (HR 1.15, 95% CI 0.92-1.43; Figure 1B) and hospitalization for major bleeding (HR 1.15, 95% CI 0.92-1.43) did not significantly differ. In multivariable analysis, the use of bevacizumab was an independent factor for VTE (HR 1.16), hospitalization for CHF (HR 1.43), new hypertension treatment (HR 1.54), and hospitalization for GI perforation (HR 2.25).

Conclusion(s): In this real-world Asian population with recurrent/metastatic colorectal cancer, bevacizumab might increase the risk of VTE, CHF, new hypertension treatment, and GI perforation compared to chemotherapy alone.