Combination Therapy Plus Maintenance Bevacizumab in First-Line NSCLC
Posted: Thursday, March 29, 2018
In treatment-naive patients with advanced nonsquamous non–small cell lung cancer (NSCLC), combination therapy with bevacizumab, cisplatin, and docetaxel followed by bevacizumab maintenance seems to be effective, despite a high incidence of grade 3/4 neutropenia in 95.7% of patients. These findings are from the phase II Thoracic Oncology Research Group (TORG) 1016 clinical trial, reported by Satoshi Ikeda, MD, of the Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan, and colleagues in BMC Cancer.
Of 47 Japanese patients enrolled in the study, 44 received 4 cycles of docetaxel (60 mg/m2), cisplatin (80 mg/m2), and bevacizumab (15 mg/kg) once every 3 weeks, and 41 (87.2%) received bevacizumab maintenance therapy every 3 weeks until disease progression or unacceptable toxicity. The median number of total treatment cycles was nine. Objective response rate, median progression-free survival, and median overall survival were 74.5%, 9 months, and 27.5 months, respectively.
On days 1 and 8 of the first cycle, the researchers conducted an exploratory analysis of circulating endothelial cells and found that median progression-free survival was longer in those with a ≥ 10 cell count increase (11 months) than in those with a < 10 count increase (6.9 months). However, the difference was not statistically significant in the 35 patients evaluated.
“The increase in [circulating endothelial cell] count between days 1 and 8 may predict the efficacy of our bevacizumab-contained treatment regimen,” concluded the investigators.
