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dc.contributor.authorCorrie, PGen_US
dc.contributor.authorMarshall, Aen_US
dc.contributor.authorNathan, PDen_US
dc.contributor.authorLorigan, Pen_US
dc.contributor.authorGore, Men_US
dc.contributor.authorTahir, Sen_US
dc.contributor.authorFaust, Gen_US
dc.contributor.authorKelly, CGen_US
dc.contributor.authorMarples, Men_US
dc.contributor.authorDanson, SJen_US
dc.contributor.authorMarshall, Een_US
dc.contributor.authorHouston, SJen_US
dc.contributor.authorBoard, REen_US
dc.contributor.authorWaterston, AMen_US
dc.contributor.authorNobes, JPen_US
dc.contributor.authorHarries, Men_US
dc.contributor.authorKumar, Sen_US
dc.contributor.authorGoodman, Aen_US
dc.contributor.authorDalgleish, Aen_US
dc.contributor.authorMartin-Clavijo, Aen_US
dc.contributor.authorWestwell, Sen_US
dc.contributor.authorCasasola, Ren_US
dc.contributor.authorChao, Den_US
dc.contributor.authorMaraveyas, Aen_US
dc.contributor.authorPatel, PMen_US
dc.contributor.authorOttensmeier, CHen_US
dc.contributor.authorFarrugia, Den_US
dc.contributor.authorHumphreys, Aen_US
dc.contributor.authorEccles, Ben_US
dc.contributor.authorYoung, Gen_US
dc.contributor.authorBarker, EOen_US
dc.contributor.authorHarman, Cen_US
dc.contributor.authorWeiss, Men_US
dc.contributor.authorMyers, KAen_US
dc.contributor.authorChhabra, Aen_US
dc.contributor.authorRodwell, SHen_US
dc.contributor.authorDunn, JAen_US
dc.contributor.authorMiddleton, MRen_US
dc.contributor.authorAVAST-M Investigatorsen_US
dc.identifier.citationAnn Oncol, 2018, 29 (8), pp. 1843 - 1852en_US
dc.description.abstractBackground: Bevacizumab is a recombinant humanised monoclonal antibody to vascular endothelial growth factor shown to improve survival in advanced solid cancers. We evaluated the role of adjuvant bevacizumab in melanoma patients at high risk of recurrence. Patients and methods: Patients with resected AJCC stage IIB, IIC and III cutaneous melanoma were randomised to receive either adjuvant bevacizumab (7.5 mg/kg i.v. 3 weekly for 1 year) or standard observation. The primary end point was detection of an 8% difference in 5-year overall survival (OS) rate; secondary end points included disease-free interval (DFI) and distant metastasis-free interval (DMFI). Tumour and blood were analysed for prognostic and predictive markers. Results: Patients (n=1343) recruited between 2007 and 2012 were predominantly stage III (73%), with median age 56 years (range 18-88 years). With 6.4-year median follow-up, 515 (38%) patients had died [254 (38%) bevacizumab; 261 (39%) observation]; 707 (53%) patients had disease recurrence [336 (50%) bevacizumab, 371 (55%) observation]. OS at 5 years was 64% for both groups [hazard ratio (HR) 0.98; 95% confidence interval (CI) 0.82-1.16, P = 0.78). At 5 years, 51% were disease free on bevacizumab versus 45% on observation (HR 0.85; 95% CI 0.74-0.99, P = 0.03), 58% were distant metastasis free on bevacizumab versus 54% on observation (HR 0.91; 95% CI 0.78-1.07, P = 0.25). Forty four percent of 682 melanomas assessed had a BRAFV600 mutation. In the observation arm, BRAF mutant patients had a trend towards poorer OS compared with BRAF wild-type patients (P = 0.06). BRAF mutation positivity trended towards better OS with bevacizumab (P = 0.21). Conclusions: Adjuvant bevacizumab after resection of high-risk melanoma improves DFI, but not OS. BRAF mutation status may predict for poorer OS untreated and potential benefit from bevacizumab. Clinical Trial Information: ISRCTN 81261306; EudraCT Number: 2006-005505-64.en_US
dc.format.extent1843 - 1852en_US
dc.titleAdjuvant bevacizumab for melanoma patients at high risk of recurrence: survival analysis of the AVAST-M trial.en_US
dc.typeJournal Article
rioxxterms.typeJournal Article/Reviewen_US
dc.relation.isPartOfAnn Oncolen_US
pubs.notesNot knownen_US
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.embargo.termsNot knownen_US
dc.contributor.icrauthorGore, Martinen_US

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