Bevacizumab-bvzr Biosimilar Used Most Frequently for Metastatic Colorectal Cancer in US Oncology Practice, According to Retrospective Cohort Study
Although bevacizumab often is used to treat solid tumors, little is known about how bevacizumab biosimilars are used to treat cancer in the United States. “Therefore, greater elucidation of how and to what extent bevacizumab biosimilars are being used in real-world U.S. oncology practice is needed,” wrote Jingyan Yang, PhD, MHS, Institute for Social and Economic Research and Policy, Columbia University, New York, NY, and colleagues.
To describe patient and provider characteristics and treatment patterns associated with the bevacizumab-bvzr biosimilar, Dr Yang and colleagues conducted a retrospective cohort study that found that US oncologists have adopted switching between the bevacizumab reference product and bevacizumab biosimilars as well as using bevacizumab-bvzr in chemotherapy combination regimens (Am J Manag Care. 2022;28(4):160-166. doi:10.37765/ajmc.2022.88831).
“Bevacizumab-bvzr has been used in all FDA-approved indications, including extrapolated indications,” noted Dr Yang and colleagues. These indications include first-line treatment of unresectable, locally advanced, recurrent, or metastatic non-squamous non–small cell lung cancer (NSCLC); metastatic renal cell carcinoma (mRCC); recurrent glioblastoma (GBM); and persistent, recurrent, or metastatic cervical cancer; and first-line or second-line treatment of metastatic colorectal cancer (mCRC).
Their study enrolled 206 patients; half were aged ≥65, 63% were female, and many were Westerners (45%). Metastatic colorectal cancer was the most common indication for bevacizumab-bvzr treatment (in 51% of patients); the next most common, in order of frequency, were cancer of the female genital organs (CFGO) (in 27%), GBM (in 11%), and NSCLC (in 9%).
“Bevacizumab-bvzr was used in both the clinically studied indication (NSCLC) and several extrapolated indications, including mCRC, CFGO, and GBM,” noted Dr Yang and the study team. “The most common indication, which was mCRC in the present study, was consistent with the literature, given that bevacizumab remains a standard-of-care therapy in mCRC. The second most common indication seen in the study was CFGO (including cervical cancer), which was supported by the total estimated number of patients exposed in the bevacizumab postmarketing setting by indication since 1997.”
The study also found that most patients with mCRC (72%) had switched to bevacizumab-bvzr from the reference drug or another bevacizumab biosimilar, and nearly half of the patients with CFGO (48%) had done so.
In addition, the study noted that for patients with mCRC or CFGO, bevacizumab-bvzr was used in chemotherapy combination regimens, “which is consistent with current treatment guidelines that report the use of bevacizumab reference product as part of a chemotherapy combination regimen,” wrote Dr Yang and the team.
“[C]oncerns around extrapolation of indications are often raised among clinicians and other key stakeholders and are considered to be a key hurdle to biosimilar usage," wrote the authors. "Hence, accumulation of real-world experience may promote clinicians’ universal acceptance of extrapolation for bevacizumab biosimilars to indications other than NSCLC, including mCRC,” Dr Yang and colleagues wrote, concluding, “However, our findings outside the indication of mCRC need to be interpreted with caution, given the limited sample size captured in the present study.”
