Real world study of regimen containing bevacizumab as first‐line therapy in Chinese patients with advanced non‐small cell lung cancer

Abstract

BackgroundLarge scale randomized controlled trials have demonstrated that the use of bevacizumab in addition to chemotherapy in patients with advanced non‐small cell lung cancer (NSCLC) conveys significant survival benefits. We explored the clinical impact of a first‐line regimen containing bevacizumab (B+) versus a non‐bevacizumab regimen (non‐B) in advanced non‐squamous NSCLC (NS‐NSCLC) patients in a real world setting.MethodsThe medical records of patients with advanced NS‐NSCLC who received first‐line therapy with or without bevacizumab were retrospectively collected. The primary outcome was progression‐free survival (PFS), with secondary objectives of objective response rate (ORR), disease control rate (DCR), and safety. Exploratory analysis of EGFR and ALK status was conducted in subgroup.ResultsOne hundred and forty‐nine patients met the selection criteria: 62 in the B+ and 87 in the non‐B group. The baseline characteristics were well balanced. In the overall population, the median PFS was significantly longer in the B+ than in the non‐B group (9.7 vs. 7.0 months, hazard ratio [HR] 0.52, 95% confidence interval [CI] 0.30–0.91; P = 0.0184). Improved trends in both ORR and DCR were observed in the B+ group. In wild‐type patients, the median PFS of the B+ was 11.3 compared to 5.5 months in the non‐B group (HR 0.43, 95% CI 0.20–0.91; P = 0.0234). In wild type and unknown populations, the median PFS was 11.3 (B+) compared to 6.0 months (non‐B) (HR 0.53; 95% CI 0.28–1.02; P = 0.0520). The safety profile was acceptable in both groups and no unexpected findings were observed.ConclusionOur analysis confirmed that a first‐line regimen containing bevacizumab showed superior clinical benefits over a non‐bevacizumab regimen in Chinese patients with advanced NS‐NSCLC in a real world setting.

A multicenter, open‐label, phase II trial of pemetrexed plus bevacizumab in elderly patients with previously untreated advanced or recurrent nonsquamous non‐small cell lung cancer

“…However, in a subset analysis of the ECOG4599 study, no additional effects of Bev were demonstrated in patients ≥70 years old, while more toxicities and a higher incidence of TRD were also observed in these patients than in those <70 years old 17 . In contrast, recent evidence has shown that Bev tends to have weak additional effects on the OS and PFS in Non‐Sq NSCLC patients >75 years old 18 and that Bev‐containing regimens have benefits over Non‐Bev regimens in a real‐world study of Non‐Sq NSCLC patients, including elderly patients 19 . Thus, regimens containing Bev might be beneficial for elderly patients with Non‐Sq NSCLC.…”

Case report: Two novel intergenic region-ALK fusions in non-small-cell lung cancer resistant to alectinib: A report of two cases

“…Bevacizumab is an anti-vascular endothelial growth factor (VEGF) monoclonal antibody that can degrade the existing tumor vascular system, inhibit the growth of new blood vessels and resist vascular permeability, thus controlling tumor growth (21)(22)(23). Studies have shown that the addition of bevacizumab significantly improves the clinical benefit of advanced nonsquamous NSCLC compared to platinum-based chemotherapy (24)(25)(26). In addition, bevacizumab was also shown to be effective in brain metastases in the BRAIN study (27).…”

Effects of anlotinib combined with second-line chemotherapy on the levels of immune cells and inflammatory factors and the curative effects in patients with advanced non-small cell lung cancer

“…For patients with positive driver gene mutation and lack of opportunity to continue targeted therapy after resistance to molecular targeted drugs, chemotherapy is often used in the second line, and there is no more effective standard second-line chemotherapy scheme, so the efficacy of the second-line treatment scheme needs to be improved urgently [9,10].…”