Reviewer's report
Title:Efficacy and safety of bevacizumab in elderly patients with metastatic
colorectal cancer: results from the Czech population-based registry
Version:1Date:23 December 2013
Reviewer: Timothy Price
Reviewer's report:
This is a well written and clear paper assessing bevacizumab effect and age. The
registry and management in centralised institutions is an interesting senario. The
equivalent survivals are also of interest. But there are limitations
The major issues are
1. The retrospective nature makes the number difficult and selection bias likely to
be very high. Only 4% of patients are over 75 years and this suggests a highly
selected group. A discussion of what these numbers mean for Czech patients is
important. ie do the authors have a feel for what proportion of patients actually
receive Bev overall, and in particular what proportion of those >75 years. The
conslusions should at least point out that these results almost certainly relate to a
very select elderly group
2. There is a need to understand who enters the data, ie is it clinicians or data
managers. This will help understand the accuracy of some of the data during a
retrospective case review.
3. The survivals are interesting but for a population based registry, an
understanding of what other data is available for Czech survivals for mCRC to
put these in perspective
4. In the discussion there is mention of the majority of patients being <65 years,
but I think the median in general is around this figure, and certainly in population
studies in some countries over 65yrs.
Minor
1. In the discussion Im not sure I agree that this is data is "real world" as it
suggests. The patients are selected and are also treated in a centralised
b=nature, something that is not common in other countries.
2. The results of GI perfs doesnt give the age breakdown in the text.
3. Reference to BRITE as a study is incorrect, it was a prospective registry in my
mind.4. As above, in the conclusion it should be noted that this data suggests
that "for a selected elderly group" Bev appears safe and probably as effective"
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
Uncompensated member of Roche Advisory Board
Reviewer's report
Title:Efficacy and safety of bevacizumab in elderly patients with metastatic
colorectal cancer: results from the Czech population-based registry
Version:1Date:23 December 2013
Reviewer: Timothy Price
Reviewer's report:
This is a well written and clear paper assessing bevacizumab effect and age. The
registry and management in centralised institutions is an interesting senario. The
equivalent survivals are also of interest. But there are limitations
The major issues are
1. The retrospective nature makes the number difficult and selection bias likely to
be very high. Only 4% of patients are over 75 years and this suggests a highly
selected group. A discussion of what these numbers mean for Czech patients is
important. ie do the authors have a feel for what proportion of patients actually
receive Bev overall, and in particular what proportion of those >75 years. The
conslusions should at least point out that these results almost certainly relate to a
very select elderly group
2. There is a need to understand who enters the data, ie is it clinicians or data
managers. This will help understand the accuracy of some of the data during a
retrospective case review.
3. The survivals are interesting but for a population based registry, an
understanding of what other data is available for Czech survivals for mCRC to
put these in perspective
4. In the discussion there is mention of the majority of patients being <65 years,
but I think the median in general is around this figure, and certainly in population
studies in some countries over 65yrs.
Minor
1. In the discussion Im not sure I agree that this is data is "real world" as it
suggests. The patients are selected and are also treated in a centralised
b=nature, something that is not common in other countries.
2. The results of GI perfs doesnt give the age breakdown in the text.
3. Reference to BRITE as a study is incorrect, it was a prospective registry in my
mind.4. As above, in the conclusion it should be noted that this data suggests
that "for a selected elderly group" Bev appears safe and probably as effective"
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
Uncompensated member of Roche Advisory Board
Please review this paper.
user
Reviewer's report
Title:Efficacy and safety of bevacizumab in elderly patients with metastatic
colorectal cancer: results from the Czech population-based registry
Version:1Date:23 December 2013
Reviewer: Timothy Price
Reviewer's report:
This is a well written and clear paper assessing bevacizumab effect and age. The
registry and management in centralised institutions is an interesting senario. The
equivalent survivals are also of interest. But there are limitations
The major issues are
1. The retrospective nature makes the number difficult and selection bias likely to
be very high. Only 4% of patients are over 75 years and this suggests a highly
selected group. A discussion of what these numbers mean for Czech patients is
important. ie do the authors have a feel for what proportion of patients actually
receive Bev overall, and in particular what proportion of those >75 years. The
conslusions should at least point out that these results almost certainly relate to a
very select elderly group
2. There is a need to understand who enters the data, ie is it clinicians or data
managers. This will help understand the accuracy of some of the data during a
retrospective case review.
3. The survivals are interesting but for a population based registry, an
understanding of what other data is available for Czech survivals for mCRC to
put these in perspective
4. In the discussion there is mention of the majority of patients being <65 years,
but I think the median in general is around this figure, and certainly in population
studies in some countries over 65yrs.
Minor
1. In the discussion Im not sure I agree that this is data is "real world" as it
suggests. The patients are selected and are also treated in a centralised
b=nature, something that is not common in other countries.
2. The results of GI perfs doesnt give the age breakdown in the text.
3. Reference to BRITE as a study is incorrect, it was a prospective registry in my
mind.4. As above, in the conclusion it should be noted that this data suggests
that "for a selected elderly group" Bev appears safe and probably as effective"
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
Uncompensated member of Roche Advisory Board
assistant