TOLERABILITYAND QUALITY OF LIFE IN ELDERLY PATIENTS TREATEDWITH BEVACIZUMAB FOR METASTATIC COLORECTAL CANCER

monoclonal antibody, in combination with regimens based on 5FU/LV (or capecitabine) ± irinotecan or oxaliplatin, considerably improved prognosis of patients with metastatic colorectal cancer (mCRC). However, potential adverse events such as hypertension, proteinuria, bleeding, gastrointestinal perforation and thrombosis should be considered especially in elderly patients. Aim of our study was to assess bevacizumab-related adverse events and their influence on quality of life in two groups of patients with mCRC. Patients and methods. From January 2008 to June 2010 we studied 59 patients with mCRC, receiving first-line chemotherapy plus bevacizumab (5 mg/kg every 2 weeks), divided in two groups, the first of 28 patients aged ≤70 years (range 35-70; mean 58.4 years) and the second of 31 patients >70 years (range 71-79; mean 72.7 years). Patients with impaired renal function and/or proteinuria ≥0.5 g/day were excluded. Adverse events were defined according to the National Cancer Institute Common Terminology Criteria (NCI-CTCAE v3.0.) Quality of life was assessed with FACT-C, EORTC-C30 and CR38 questionnaires. Patients were evaluated at baseline, at each cycle of therapy, three and six months after the end of chemotherapy. Results. Any grade hypertension occurred in 7 (25%) patients ≤70 years and in 9 (29%) older patients. Grade 3 hypertension, requiring the initiation or a change of antihypertensive therapy, was observed in 3 (10.7%) patients ≤70 years and in 4 (12.9%) patients >70 years. Proteinuria occurred in 8 (28.6%) patients ≤70 years and in 9 (29%) older patients. Grade 4 hypertension (hypertensive crisis) and/or grade 4 proteinuria (nephrotic syndrome) was not seen. The FACT-C and EORTC questionnaires showed that bevacizumab-related side effects had no impact on quality of life. Conclusion. In our study combination therapy with bevacizumab was well tolerated with a generally manageable safety profile in all patients. Bevacizumab-related adverse events such as hypertension and proteinuria, while noting more prevalent in patients aged >70 years, had no significant effects on quality of life.