Survival Update With Bevacizumab Plus Erlotinib in Certain Patients With NSCLC
Posted: Friday, July 31, 2020
A study published in May 2019 suggested that adding bevacizumab to erlotinib monotherapy would lead to an increase in both progression-free and overall survival in patients with EGFR-mutant non–small cell lung cancer (NSCLC). However, longer follow-up suggests the benefit of adding bevacizumab gradually decreases, and there is no apparent significant difference in survival. This final analysis of the phase III NEJ026 study was presented by Makoto Maemondo, MD, PhD, of Iwate Medical University, Morioka, Japan, and colleagues during the ASCO20 Virtual Scientific Program (Abstract 9506).
This study enrolled 226 patients with chemotherapy-naive, advanced nonsquamous, NSCLC with EGFR mutations. Patients were randomly assigned to receive either 150 mg of erlotinib daily plus 15 mg/kg of bevacizumab every 3 weeks (n = 112) or erlotinib alone (n = 114). There were 29 patients (25.9%) in the bevacizumab group and 26 patients (23.2%) in the erlotinib-alone group who received osimertinib as a second line treatment.
After a median follow-up of 39.2 months, the median overall survival with bevacizumab plus erlotinib was 50.7 months, compared with 46.2 months with erlotinib alone (hazard ratio = 1.00). The median time between enrollment and progressive disease after second-line treatment was 28.6 months and 24.3 months with bevacizumab and erlotinib alone, respectively. In both the combination-therapy group and the monotherapy group, the median overall survival of patients who received osimertinib in the second line was longer than in other second-line chemotherapy groups. The overall survival in the group receiving osimertinib was 50.7 months, compared with 40.1 months in the other group (hazard ratio = 0.695).
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