1. Impact of prolonged and early bevacizumab treatment on the overall survival of EGFR‐mutant and EGFR‐wild type nonsquamous non‐small cell lung cancer
- Author
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Huang, Yu‐Chen, Shen, Shih‐Min, Liu, Chien‐Ying, Pavlidis, Stelios, Wang, Chih‐Liang, Ko, How‐Wen, Chung, Fu‐Tsai, Lin, Tin‐Yu, Feng, Po‐Hao, Lee, Kang‐Yun, Guo, Yi‐Ke, Yang, Cheng‐Ta, and Kuo, Chih‐Hsi Scott
- Subjects
Adult ,Aged, 80 and over ,Male ,Lung Neoplasms ,EGFR ,Original Articles ,Kaplan-Meier Estimate ,Middle Aged ,NSCLC ,VEGF ,Time-to-Treatment ,Bevacizumab ,ErbB Receptors ,Antineoplastic Agents, Immunological ,Treatment Outcome ,Carcinoma, Non-Small-Cell Lung ,Antineoplastic Combined Chemotherapy Protocols ,Mutation ,Humans ,Original Article ,Female ,Aged ,Neoplasm Staging ,Proportional Hazards Models ,Retrospective Studies - Abstract
Background VEGF plays a key role in tumor angiogenesis and immunosuppression. VEGF‐blocking has proven beneficial for EGFR mutant and wild‐type nonsquamous non‐small cell lung cancer (nonsq‐NSCLC); however, the number of cycles and treatment line yielding the optimal benefit are unknown. Methods We retrospectively analyzed the data of 115 patients with advanced/metastatic nonsq‐NSCLC administered at least one cycle of bevacizumab. The number of bevacizumab cycles was treated as a time‐dependent covariate. Predictors of overall survival (OS) were investigated. Results Bevacizumab was used as first‐line treatment in 47 (40.9%) patients, with a median of five cycles (range: 1–31). Eastern Cooperative Oncology Group performance status ≥ 2 (hazard ratio [HR] 4.78, 95% confidence interval [CI] 2.68–8.51; P < 0.001), wild‐type EGFR (HR 2.61, 95% CI 1.45–4.70; P = 0.001), and bleeding during bevacizumab treatment (HR 3.63, 95% CI 1.77–7.45; P < 0.001) were predictive of poor OS; the number of bevacizumab cycles and first‐line administration were not. In the wild‐type EGFR subgroup, the number of bevacizumab cycles (≥ 5 vs. 1–4) was associated with a significant OS benefit (HR 0.28, 95% CI 0.08–0.98; P = 0.044); first‐line administration also showed an OS benefit (HR 0.48, 95% CI 0.20–1.17; P = 0.105). A significant association between the number of cycles and EGFR status was identified (P = 0.046). Conclusion OS benefit is negatively affected by bleeding events in bevacizumab‐treated patients. Prolonged and early introduction of bevacizumab may provide an OS benefit for patients with wild‐type EGFR nonsq‐NSCLC.
- Published
- 2018