Safety of Bevacizumab in Patients With Non–Small-Cell Lung Cancer and Brain Metastases

Socinski, Mark A.; Langer, Corey J.; Huang, Jane; Kolb, Margaret M.; Compton, Peter; Wang, Lisa; Akerley, Wallace

doi:10.1200/jco.2009.22.0616

Cited by 213 publications

(143 citation statements)

References 19 publications

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“…In this respect, the safety of the combination of chemotherapy with Bev and brain radiotherapy has been previously documented in patients with non-SCLC. 32 In the recent Safety Evaluation of a Combination of Brain Radiation Therapy and Bevacizumab for Treatment of Brain Metastasis (REBECA) phase I trial Bev was evaluated in combination with WBRT in patients with brain metastases from solid tumors and achieved some encouraging results, which suggested a potential synergistic effect between Bev and radiation therapy. 33 In this regard, it should be also noted that the bloodebrain barrier is disrupted during brain radiotherapy, hence, the penetration of chemotherapy drugs and Bev through it might be facilitated.…”

Section: Discussionmentioning

confidence: 99%

Cisplatin, Etoposide, and Bevacizumab Regimen Followed by Oral Etoposide and Bevacizumab Maintenance Treatment in Patients With Extensive-Stage Small Cell Lung Cancer: A Single-Institution Experience

Petrioli

Roviello

Laera

et al. 2015

Clinical Lung Cancer

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Section: Discussionmentioning

confidence: 99%

Cisplatin, Etoposide, and Bevacizumab Regimen Followed by Oral Etoposide and Bevacizumab Maintenance Treatment in Patients With Extensive-Stage Small Cell Lung Cancer: A Single-Institution Experience

Petrioli

Roviello

Laera

et al. 2015

Clinical Lung Cancer

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“…Patients with brain metastases were excluded from both trials due to concerns that bevacizumab may increase the risk of intracranial hemorrhage. The safety of bevacizumab in patients with treated brain metastases was subsequently established by the PASSPORT trial [Socinski et al 2009] and generally manageable toxicity of bevacizumab was confirmed in the SAIL study, an open-label phase IV study, which did not reveal any new safety signals [Crino et al 2010].…”

Section: Vegfmentioning

confidence: 99%

Targeted therapy of non-small-cell lung carcinoma

Tiwari

Brodie²,

Brandes³

2011

Ther Adv Respir Dis

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The rapid expansion of novel technologies in cancer research over the past several years has led to a dramatically improved understanding of the molecular biology of lung cancer. As a consequence, novel targeted therapies are rapidly being developed. In this review, we summarize the most important molecular pathways in lung cancer and describe the clinical evidence for the development of therapies against these targets. Keywords: lung cancer, targeted therapy, EGFR, VEGF IntroductionWith an estimated 222,000 new cases and an estimated 157,000 deaths in the United States for the year 2010, lung cancer remains the most deadly malignancy and accounts for as many deaths as colon, breast, and prostate cancers combined [Jemal et al. 2010]. Lung-cancer-specific survival rates, however, have improved slightly since the 1990s [Owonikoko, 2010], which gives us reason to hope that better understanding of the underlying molecular etiology of lung cancer and the development of better treatment approaches including targeted therapies will have a growing clinical impact. In this review, we describe the most relevant molecular and biochemical pathway alterations in lung cancer and review the clinical evidence of novel therapies aimed at those molecular targets.

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“…Among 743 patients included in the final analyses, 29 presented BM at baseline. A pooled analyses (33) of the 131 patients with treated BM receiving bevacizumab in either PASSPORT (28) or ATLAS (29) reported no symptomatic grade >2 brain haemorrhage during the main treatment phases of study. In the ATLAS trial one grade 2 CNS haemorrhage occurred during treatment after CNS progression (29).…”

Section: Angiogenesis In Brain Metastasesmentioning

confidence: 99%

“…Bevacizumab safety was first investigated in patients with asymptomatic treated BM. Five prospective trials, PASSPORT, ATLAS, BeTa, ERACLE and PRONOUNCE trials included patients with treated BM and recorded a low rate of CNS haemorrhage (28)(29)(30)(31)(32).…”

Section: Angiogenesis In Brain Metastasesmentioning

confidence: 99%

Anti-angiogenetic therapies for central nervous system metastases from non-small cell lung cancer

Buttigliero

Bertaglia

Novello

2016

Transl. Lung Cancer Res.

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Central nervous system (CNS) metastases are common in patients with advanced non-small cell lung cancer (NSCLC), occurring in 24% to 44% of patients in the course of their disease and confer significant morbidity and mortality. Systemic therapies have been deemed ineffective in brain metastases (BM) under the hypothesis that the blood-brain barrier (BBB) limits their delivery to the brain. Angiogenesis, which is mainly mediated by vascular endothelial growth factor (VEGF) pathway, is crucial for tumor survival, growth and invasion both in primary and metastatic brain lesions. Two major categories of agents have been developed to target this pathway: antibody-based agents and VEGF receptor tyrosine kinase inhibitors (TKIs). Clinical benefits have been shown with anti-angiogenetic therapies in the treatment of metastatic NSCLC. However, patients with CNS metastases were often excluded from trials with these agents, due to concerns about a potentially greater risk of cerebral haemorrhage and thromboembolic disease. Therefore, the overall efficacy and safety of angiogenetic agents in patients with BM from NSCLC are yet to be clarified. This paper aims to review available data about the efficacy and safety of antiangiogenetic therapies for CNS metastases in NSCLC patients.

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Safety of Bevacizumab in Patients With Non–Small-Cell Lung Cancer and Brain Metastases

Abstract: Addition of bevacizumab to various chemotherapy agents or erlotinib in patients with NSCLC and treated brain metastases seems to be safe and is associated with a low incidence of CNS hemorrhage.

Cited by 213 publications

References 19 publications

Cisplatin, Etoposide, and Bevacizumab Regimen Followed by Oral Etoposide and Bevacizumab Maintenance Treatment in Patients With Extensive-Stage Small Cell Lung Cancer: A Single-Institution Experience

Cisplatin, Etoposide, and Bevacizumab Regimen Followed by Oral Etoposide and Bevacizumab Maintenance Treatment in Patients With Extensive-Stage Small Cell Lung Cancer: A Single-Institution Experience

Targeted therapy of non-small-cell lung carcinoma

Anti-angiogenetic therapies for central nervous system metastases from non-small cell lung cancer

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