EGFR+ NSCLC: frontline bevacizumab-erlotinib combo delays progression

  • Lancet Oncol

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Erlotinib+bevacizumab extended median PFS vs erlotinib alone as first-line therapy for EGFR-positive NSCLC.

Why this matters

  • These preliminary findings in this phase 3 trial confirm results reported from phase 2.

Study design

  • Interim analysis of a randomized, open-label, phase 3 NEJ026 trial.
  • 224 patients with stage IIIB-IV disease or recurrent, cytologically or histologically confirmed nonsquamous NSCLC with activating EGFR mutations received erlotinib+bevacizumab (n=112) or erlotinib alone (n=112).
  • Funding: Chugai Pharmaceutical.

Key results

  • Median PFS was 16.9 months with erlotinib plus bevacizumab and 13.3 months with the erlotinib-alone group (HR, 0.605; P=.016).
  • The combination therapy group had a better objective response (72% vs 66%; P=.31) than the monotherapy group.
  • The combination therapy group had significantly more grade ≥3 adverse events (AEs: 88% vs 46%) and serious AEs (8% vs 4%).
    • Rash was the most common grade 3-4 AE.
    • Grade 4 neutropenia and grade 4 hepatic dysfunction were the most common serious AEs.

Limitations

  • Small sample size.
  • Underpowered for subgroup analysis.

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