- Adding bevacizumab to standard frontline erlotinib failed to extend progression-free survival (PFS) in a phase 2 trial of patients with epidermal growth factor receptor mutation-positive (EGFR+) NSCLC.
Why this matters
- Previous trials had suggested benefit for combination therapy.
- Multicenter phase 2 clinical trial of 88 patients (median age, 63 [range, 31-84] years; 70% women) with stage IV EGFR+ NSCLC randomly assigned to receive erlotinib with or without bevacizumab, continued until disease progression, unacceptable adverse event, or withdrawal of consent.
- 85% were white, and 55% were never-smokers.
- Median follow-up was 33 (range, 0.7-62.5) months.
- Funding: Genentech/Roche.
- Combination therapy vs erlotinib alone showed no significant benefit in terms of:
- PFS: median, 17.9 vs 13.5 months (HR, 0.81; P=.39).
- Objective response rate: 81% vs 83% (P=.81).
- OS: median, 32.4 vs 50.6 months (HR, 1.41; P=.33).
- Grade ≥3 adverse events reported more commonly with combination therapy included skin eruptions (26% vs 16%), hypertension (40% vs 20%), and proteinuria (12% vs 0%).
- Small sample size with few events.
- Few circulating free DNA blood samples collected.