title: Combination of paclitaxel and bevacizumab in heavily pre-treated non-small-cell lung cancer (NSCLC) patients: a case series study on 15 patients.
abstract: BACKGROUND
  The combination of paclitaxel and bevacizumab was EMA-approved as first-line therapy in metastatic breast cancer. Moreover, in vitro studies showed a potential antiangiogenic synergistic effect of paclitaxel and bevacizumab.
  
  
  METHODS
  Between November 2008 and March 2010, this case series study included 15 patients with metastatic non squamous-cell lung carcinoma (NSCLC). Those were bevacizumab eligible and received the same regimen used in metastatic breast cancer with weekly paclitaxel (80 mg/m(2), days 1, 8 and 15) and bevacizumab (10 mg/kg at days 1 and 15) after at least one prior line of chemotherapy. Efficacy was evaluated by CT-scan and PET-FDG every two months. Circulating endothelial progenitor cells (CEP) and circulating endothelial cells (CEC) levels were explored in a subset of patients.
  
  
  RESULTS
  Median age 56 (36-75), female: 47%, never smokers: 27%, adenocarcinoma: 100%, PS 0-1: 87% and PS 3: 13%. All patients were treated with a first-line platinum-based doublet with or without bevacizumab and 70% of them with erlotinib in the second-line. No major toxicity was observed. Partial response (PR) rate was 44% (31-63%) using RECIST criteria on CT-scan, and 65% (29-88%) with PET FDG. PS improved in 33% of the cases. Median progression free survival was 4.6 months. An increase of CEC and CEP was observed in patients with NSCLC treated with paclitaxel and bevacizumab.
  
  
  CONCLUSIONS
  In this retrospective series, our results suggest efficacy signal in pre-treated metastatic NSCLC and warrant further assessment in a randomized clinical trial.
authors: Hôpital du Val-de-Grâce, service d'oncologie médicale, 74, boulevard de Port-Royal, 75005 Paris, France.
authors: Sylvestre
authors: S
authors: Le Moulec
authors: Gustave-Roussy Campus Cancer, 94805 Villejuif, France.
authors: Julien
authors: J
authors: Hadoux
authors: Hôpital du Val-de-Grâce, service d'oncologie médicale, 74, boulevard de Port-Royal, 75005 Paris, France.
authors: Eric
authors: E
authors: Gontier
authors: Hôpital du Val-de-Grâce, service d'oncologie médicale, 74, boulevard de Port-Royal, 75005 Paris, France.
authors: Cyrus
authors: C
authors: Chargari
authors: Hôpital du Val-de-Grâce, service d'oncologie médicale, 74, boulevard de Port-Royal, 75005 Paris, France.
authors: Carole
authors: C
authors: Helissey
authors: Hôpital du Val-de-Grâce, service d'oncologie médicale, 74, boulevard de Port-Royal, 75005 Paris, France.
authors: Virginie
authors: V
authors: Lamand
authors: Hôpital du Val-de-Grâce, service d'oncologie médicale, 74, boulevard de Port-Royal, 75005 Paris, France.
authors: Rachid
authors: R
authors: Tanz
authors: Gustave-Roussy Campus Cancer, 94805 Villejuif, France.
authors: Françoise
authors: F
authors: Farace
authors: Hôpital du Val-de-Grâce, service d'oncologie médicale, 74, boulevard de Port-Royal, 75005 Paris, France.
authors: Lionel
authors: L
authors: Vedrine
authors: Hôpital du Val-de-Grâce, service d'oncologie médicale, 74, boulevard de Port-Royal, 75005 Paris, France.
authors: Gérald
authors: G
authors: Bonardel
authors: Gustave-Roussy Campus Cancer, 94805 Villejuif, France.
authors: Jean-Charles
authors: JC
authors: Soria
authors: Gustave-Roussy Campus Cancer, 94805 Villejuif, France.
authors: Benjamin
authors: B
authors: Besse
mesh_terms: D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D000068258:Bevacizumab; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D004334:Drug Administration Schedule; D042783:Endothelial Cells; D000069347:Erlotinib Hydrochloride; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000009:adverse effects / Q000627:therapeutic use*; D011799:Quinazolines / Q000627:therapeutic use; D012189:Retrospective Studies; D013234:Stem Cells
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000972:Antineoplastic Agents, Phytogenic; D011799:Quinazolines; D000068258:Bevacizumab; D000069347:Erlotinib Hydrochloride; D017239:Paclitaxel
keywords: 2nd or 3rd line of NSCLC; bevacizumab; paclitaxel weekly