Platinum-Vinorelbine Induction Chemotherapy plus Bevacizumab With and Without Pemetrexed Switch Maintenance in Advanced NSCLC.
BACKGROUND
Little information is available until today regarding the effect of platinum-doublet chemotherapy with bevacizumab followed by pemetrexed as a sole maintenance treatment. Original data concerns different induction regimens plus bevacizumab with bevacizumab maintenance to progression in advanced non-squamous non-small cell lung cancer (NSCLC).


METHODS
Two consecutive groups of patients with advanced non-squamous NSCLC received carboplatin, vinorelbine and bevacizumab for four cycles. Group A (2010-2012) did not receive any maintenance therapy, whereas group B (2012-2013) received pemetrexed switch maintenance (500 mg/m(2)) every three weeks until disease progression.


RESULTS
The median progression-free survival (PFS) was 4.4 months and 7.3 months (p<0.001) and one-year survival was 42% and 52% for Group A (n=20) and B (n=22) patients, respectively. Disease control rates were 65% and 86% (p=0.104). Deep venous thrombosis and pulmonary embolism occurred in three (15%) and seven (32%) patients in group A and B, respectively.


CONCLUSIONS
The inferior PFS (p<0.001) without maintenance suggests that induction treatment including bevacizumab should not be planned without subsequent maintenance treatment. Whether it is better to use pemetrexed or bevacizumab, or a combination of both, as maintenance therapy is not yet established.
Department of Oncology, Finsen Centre-National University Hospital, Copenhagen, Denmark linmi@regionsjaelland.dk jens.benn.soerensen@regionh.dk.
Linda
L
Michelsen
Department of Oncology, Finsen Centre-National University Hospital, Copenhagen, Denmark linmi@regionsjaelland.dk jens.benn.soerensen@regionh.dk.
Jens Benn
JB
Sørensen
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000008:administration & dosage; D018287:Carcinoma, Large Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D060828:Induction Chemotherapy; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D000068437:Pemetrexed / Q000008:administration & dosage; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine; D055815:Young Adult
D000068437:Pemetrexed; D000068258:Bevacizumab; D014747:Vinblastine; D002945:Cisplatin; D000077235:Vinorelbine
Lung cancer; bevacizumab; maintenance treatment; non-small cell lung cancer; overall survival; pemetrexed; platinum-based chemotherapy; progression-free survival