Phase 2 trial of maintenance bevacizumab alone after bevacizumab plus pemetrexed and carboplatin in advanced, nonsquamous nonsmall cell lung cancer
Stevenson JP et al. – Combined bevacizumab, pemetrexed, and carboplatin followed by maintenance bevacizumab was well tolerated and displayed remarkable activity in patients with previously untreated, advanced, nonsquamous nonsmall cell lung cancer.Methods
- Previously untreated patients with advanced, nonsquamous nonsmall cell lung cancer and an Eastern Cooperative Oncology Group performance status of 0 or 1 received bevacizumab 15mg/kg, pemetrexed 500mg/m2 and carboplatin at an area under the concentration-time curve of 6 intravenously on day 1 every 21days.
- Responding or stable patients who completed 6 cycles then received bevacizumab maintenance every 21days until disease progression.
- In total, 43 patients (40 who were evaluable for response) were entered on the study.
- Treatment-related grade 3/4 toxicities were low and included febrile neutropenia (2%), neutropenia (28%), anemia (18%), thrombocytopenia (11%), hypertension (7%), epistaxis (5%), venous thrombosis (8%), dyspnea (7%), rectovaginal fistula (2.3%), infusion reaction (2%), and cerebrovascular event (2%).
- One patient died from complications of venous thromboembolism and cerebrovascular accident after Cycle 2.
- Minimal clinically significant toxicity occurred during maintenance bevacizumab.
- Two complete responses (5%) were observed, and 17 patients (42%) had a partial response.
- Fifteen patients (38%) displayed disease stability.
- The overall disease control rate was 85%.
- At a median follow-up of 15.8months, the median progression-free survival was 7.1months (95% confidence interval, 5.9-8.3months), and the median overall survival was 17.1months (95% confidence interval, 8.8-25.5months).