Should Bevacizumab Accompany Adjuvant Chemotherapy in Early-Stage NSCLC?
Posted: Monday, January 15, 2018
Overall survival of patients with early-stage, surgically resected non–small cell lung cancer (NSCLC) did not improve when bevacizumab was added to adjuvant chemotherapy, according to a 6-year study. The treatments of more than 1500 patients were analyzed by Heather A. Wakelee, MD, of Stanford Cancer Institute in California, and colleagues, who published their results in The Lancet Oncology.
In fact, the authors concluded decisively, “Bevacizumab does not have a role in this setting.”
Between 2007 and 2013, 749 patients who had completely resected stage 1B–IIIA NSCLC were randomly assigned to the chemotherapy-alone group, whereas 752 similar patients were assigned to receive chemotherapy plus bevacizumab. Four cisplatin-based chemotherapies were used: pemetrexed (33%), vinorelbine (25%), docetaxel (23%), and gemcitabine (19%).
Although mortality did not significantly differ between the two groups at a median follow-up of 50.3 months, the estimated median overall survival in the chemotherapy-only group had not been reached at that point, whereas it was 85.8 months in the chemotherapy-plus-bevacizumab group.
Also, grade 3–5 toxicities occurred in 83% of the bevacizumab group versus 67% of the chemotherapy-only group, further supporting the authors’ strong recommendation that bevacizumab “should not be considered as an adjuvant therapy for patients with resected early-stage NSCLC.”