Treatment with or without bevacizumab as a first‐line and maintenance therapy for advanced non‐squamous non‐small cell lung cancer: A retrospective study

摘要

BACKGROUND:Pemetrexed and bevacizumab as monotherapies, or in combination, have been approved for maintenance therapy following platinum-based induction in patients with advanced nonsquamous non-small cell lung cancer (NSCLC). The differences in the benefits of bevacizumab for treatment during early or late NSCLC have not yet been characterized.METHODS:We retrospectively analyzed data from 35 patients with advanced na?ve NSCLC who had received pemetrexed/platinum with or without bevacizumab followed by maintenance therapy with pemetrexed alone or pemetrexed plus bevacizumab. The data were analyzed using the Kaplan-Meier method and Cox regression adjusted for risk factors. Patients were grouped according to treatment conditions. Group A received pemetrexed plus platinum followed by pemetrexed alone (Pem-Pt/Pem). Group B received pemetrexed plus platinum followed by pemetrexed and bevacizumab (Group B; Pem-Pt/Pem? ?Bev). Group C received pemetrexed, platinum, and bevacizumab during induction therapy, and pemetrexed as maintenance therapy (Group C; Pem-Pt? ?Bev/Pem? ?Bev). We assessed the significance of introduction of bevacizumab at different stages of treatment.RESULTS:A total of 13 (37.1%) patients were included in Group A, nine patients (25.7%) were included in Group B, and 13 patients (37.1%) were included in Group C. Among the 35 patients, 69.2% were male, and the median age was 59?years (range 40-75). The median progression-free survival (PFS) was 7.7 months (231?days, range 134-410?days) in Group A, 9.3 months (280?days, range 84-565?days) in Group B, and 8.0 months (241?days, range 108-665?days) in Group C. The median PFS was not significantly different among the three groups (P = 0.233). Similarly, bevacizumab did not significantly affect PFS (P = 0.630).CONCLUSIONS:The addition of bevacizumab into induction chemotherapy or maintenance therapy provided limited benefits to PFS in our study, but previous studies suggested that bevacizumab may improve disease control. In that way, we presume that early use of bevacizumab may provide a greater benefit.? 2020 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.