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- W2891483775 abstract "e18250 Background: Bevacizumab (Bev) can be associated with clinically significant bleeding. Patients (pts) in community practice have increased comorbidities, leading to some reluctance to use Bev with anticoagulation (AC) or antiplatelet therapy (APT). This study was conducted to determine the incidence of Bev induced bleeding in colorectal (CRC) and non-colorectal (non-CRC) cancer pts in a real-world setting. Methods: In this retrospective analysis, pts with Bev treated CRC and non-CRC from Jan 2010 to Jan 2017 at our hospital were identified. Bleeding was graded according to CTCAE v4.0. Chi-Square and ANOVA were used to calculate associations. Overall survival (OS) and progression free survival (PFS) were calculated using Kaplan-Meier and log rank methods. Results: 241 pts were evaluated (mean age = 63; 54% females), 112 with CRC and 129 with non-CRC (lung = 27%; gynecologic = 14%; CNS = 7%; other = 5%). Median duration of Bev therapy was 21 weeks. Overall bleeding was 22% (mucocutaneous = 14%; hematochezia = 4.5%; hematemesis = 1%; hematuria 2.5%; cerebral hemorrhage = 1%). Grade 3 bleeding occurred in 8 pts (epistaxis = 1; hematemesis = 2; hematochezia = 1; hematuria = 4), of whom 1 was on AC. There were no grade > 3 events. Concomitant AC (n = 35) increased bleeding risk ( p = 0.01) whereas APT (n = 43) did not ( p = 0.4). There was no association of bleeding and Bev dose ( p = 0.1); however, longer duration of therapy increased bleeding risk ( p = 0.01). In CRC pts, concomitant chemotherapy (oxaliplatin vs irinotecan), bleeding history, intact tumors and tumor side were not associated with increased risk ( p > 0.05). In CRC, pts with bleeding had longer estimated median OS (52 [95%CI, 35-66] vs 35 [95%CI, 22-48] months; p= 0.079) and PFS (80 [95%CI, 59-101] vs 72 [95%CI, 49-95] months; p= 0.048). Conclusions: We demonstrated in a modern community hospital practice that there is a 22% incidence of bleeding with Bev, although mostly mild even with concurrent AC, and only 3% grade 3. Concurrent AC but not APT was associated with increased bleeding risk and warrants careful discussion with pts. The observation of longer OS and PFS in pts with Bev induced bleeding warrants further investigation." @default.
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- W2891483775 date "2017-05-20" @default.
- W2891483775 modified "2023-09-27" @default.
- W2891483775 title "Bevacizumab-induced bleeding in colorectal and noncolorectal cancer patients in a community oncology setting: An Abington Memorial Hospital experience." @default.
- W2891483775 doi "https://doi.org/10.1200/jco.2017.35.15_suppl.e18250" @default.
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