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Adding Bevacizumab to Carboplatin/Pemetrexed in Nonsquamous NSCLC

By: Dana A. Elya, MS, RD, CDN
Posted: Monday, June 24, 2019

The addition of bevacizumab to carboplatin/pemetrexed in the treatment of advanced nonsquamous non–small cell lung cancer (NSCLC) seems to provide a modest but consistent survival benefit. This new research, published in JNCCN—Journal of the National Comprehensive Cancer Network, is based on a large real-world data set of more than 4,700 patients with lung cancer treated from 2011 to 2017 at more than 260 community cancer clinics.

“Our results suggest that in patients with a contraindication to immunotherapy…, bevacizumab may be a reasonable alternative, instead of pembrolizumab, to add to carboplatin/pemetrexed,” said Stephen J. Bagley, MD, MSCE, of the University of Pennsylvania, Abramson Cancer Center, Philadelphia, in a press release. “What’s more, I was surprised to learn that the survival benefit of bevacizumab persisted even in older patients and after adjusting for brain metastases, hemoptysis, and anticoagulation use.”

The retrospective study focused on data from electronic health records of 4,724 patients diagnosed with advanced stage IV or metastatic/recurrent NSCLS. A total of 2,759 of the patients (58%) received carboplatin/pemetrexed, whereas 1,965 patients (42%) received carboplatin, pemetrexed, and bevacizumab.

With an average follow-up of 23.5 months, the median overall survival improved to 12.1 months in the bevacizumab group compared with 8.6 months in the group without bevacizumab (even after the investigators adjusted for prognostic variables). In addition, the overall survival benefit was even greater when bevacizumab was added to the combination therapy in a second cohort of patients from Abramson Cancer Center.

“Results of our real-world study provide essential information that can be incorporated into the complex clinical decision-making necessary for this large population of patients with cancer,” the investigators concluded.

Disclosure: The study authors’ disclosure information may be found at jnccn.org.



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