EFFICACY AND SAFETY OF BEVACIZUMAB IN COMBINATION WITH CARBOPLATIN AND PACLITAXEL FOR PATIENTS WITH ADVANCED EGFR MUTATION-POSITIVE NON-SMALL CELL LUNG CANCER

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Abstract

Background

Efficacy of bevacizumab in combination with platinum-based chemotherapy for EGFR mutation-positive non-small-cell lung cancer (NSCLC) is less well known. The purpose of this study was to determine the efficacy and safety of bevacizumab with carboplatin plus paclitaxel for patients with advanced EGFR mutation-positive NSCLC.

Methods

We retrospectively reviewed 22 consecutive patients with advanced EGFR mutation-positive NSCLC treated with bevacizumab with carboplatin plus paclitaxel at our institution from April 2010 to September 2011. Carboplatin AUC 6 and paclitaxel 200 mg/m2 for up to six cycles plus bevacizumab 15 mg/kg were administered intravenously every 3–4 weeks until disease progression or development of intolerance.

Results

Profile of patients included: median age was 63 years (range 36–71); male/female = 7/15; PS 0/1 = 4/18; EGFR mutation type exon 19 deletion/L858R in exon 21 = 11/11 and all patients had stage IV adenocarcinoma. Thirteen patients had received no prior chemotherapy and nine patients had been treated with EGFR tyrosine kinase inhibitors (EGFR TKIs). A partial response was achieved in 8 of 22 patients, and the overall response rate was 36%. The median progression-free survival (PFS) in all patients was 8.9 months. The response rate of patients who had received prior EGFR TKIs was 44% (4 of 9), as opposed to 31% (4 of 13) among untreated patients (P = 0.66). Median PFS was 8.9 months in prior EGFR TKIs-treated patients, compared with 6.1 months in untreated patients (P = 0.66). The median overall survival has not been reached. The most common adverse events were grade 3/4 neutropenia (45%) and grade 1 bleeding events (50%). There were no severe pulmonary hemorrhage and treatment-related deaths.

Conclusions

In patients with advanced EGFR mutation-positive NSCLC, prior EGFR TKIs therapy status is not significantly associated with efficacy of bevacizumab with carboplatin plus paclitaxel.

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