Real world study of the continuation of bevacizumab beyond disease progression after first-line treatment containing bevacizumab in Chinese patients with advanced non-small cell lung cancer

Thorac Cancer. 2018 Dec;9(12):1716-1724. doi: 10.1111/1759-7714.12886. Epub 2018 Oct 16.

Abstract

Background: Bevacizumab (Bev) plus platinum-based chemotherapy is a standard first-line treatment option for advanced non-squamous non-small cell lung cancer (NS-NSCLC). We evaluated the efficacy and safety of continuing Bev in Chinese patients with advanced NS-NSCLC progression after first-line treatment containing Bev in a real-world setting.

Methods: The data of 118 patients with advanced NS-NSCLC who received Bev between July 2009 and July 2017 were retrospectively collected. The patients were divided into groups: 15 in Bev first-line, 82 in Bev ≥ second-line, and 21 in Bev cross-lines. The primary endpoint was overall survival; secondary objectives were progression-free survival, objective response rate, disease control rate, and safety.

Results: The overall survival was 21.8, 32.5, and 18.9 months (P = 0.092) in the overall population and 39.3, 25.8, and 15.0 months (P = 0.347) in the wild-type population in the Bev first-line, Bev ≥ second-line, and Bev cross-lines groups, respectively. There were no significant differences in progression-free survival of second-line treatment between the groups in the overall population: 2.6, 3.7, and 3.2 months in the Bev first-line, Bev ≥ second-line, and Bev cross-lines groups, respectively (P = 0.796). No statistically significant improvement in objective response or disease control rates in the Bev cross-lines group was observed. No unexpected or severe adverse events were recorded.

Conclusion: We found no benefit in continuing Bev treatment beyond progression after first-line treatment containing Bev for patients with advanced NS-NSCLC. Further research of validated predictive biomarkers of response to treatment after long-term antiangiogenic therapy is required.

Keywords: Bevacizumab; beyond progression; non-small cell lung cancer; overall survival; safety.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bevacizumab / administration & dosage
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / genetics
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / pathology*
  • Disease Progression
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / genetics
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Retreatment
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Bevacizumab