How many colorectal cancer (CRC) patients older than 70 years may be safely treated with bevacizumab?

13589 Background: While age-associated comorbidities are not usually an obstacle to the administration of chemotherapy regimens for CRC, they could instead limit the access to an anti-angiogenic therapy. Hypertension, proteinuria, arterial thrombosis, bleeding and gastrointestinal perforation are the principal bevacizumab (Avastin®)-related events. The aim of this analysis was to estimate the percentage of patients ≥ 70 years potentially amenable with bevacizumab, taking into account age-associated cardiovascular, gastrointestinal (GI) or kidney diseases possibly interfering with its administration. Methods: From January 2004 to December 2005, 91 consecutive patients older than 70, with histologically proven CRC adenocarcinoma for whom chemotherapy had been planned (44 as an adjuvant treatment, 30 as a palliative therapy, 17 for a neoadjuvant program) and entered in our Geriatric Oncology Program, were analysed. Principal variables considered were age and the afore mentioned comorbidities. Results: Median age was 76 years (range, 70–84) and the male:female ratio, 62:28. Sixty-five patients (71.4%) had associated comorbidities. Of these, 39 had cardiovascular-, 17 had cardiovascular and GI-, 5 GI-, 2 kidney and cardiovascular-, and 2 kidney, cardiovascular and GI-associated diseases. Twenty nine out 91 (31.9%) cases presented a grade ≥ 2 either cardiovascular or GI or kidney comorbidities according to the Cumulative Illness Rating Scale-Geriatric (CIRS-G) score, 36 (39.5%) a grade 1 and 26 (28.6%) no comorbidities. Conclusions: In view of the most common bevacizumab-related adverse events, almost one third of our CRC patients with cardiovascular, GI- or kidney- associated diseases of CIRS grade ≥ 2 could have been considered at high risk for its administration. Also in about 40% of patients with CIRS grade 1 still the use of bevacizumab could have been questionable. Then less than in one third of our patients older than 70 years bevacizumab could have been safely administered. No significant financial relationships to disclose.