NSCLC: adding bevacizumab ups survival with carboplatin-pemetrexed

  • Bagley SJ & al.
  • J Natl Compr Canc Netw
  • 1 May 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Adding frontline bevacizumab to carboplatin/pemetrexed for metastatic nonsquamous NSCLC was associated with significantly improved OS, even after adjusting for potential confounders.

Why this matters

  • Although bevacizumab/carboplatin/pemetrexed is commonly used in clinical practice, there have been no randomized controlled trials establishing survival benefit, and the triple regimen is not recommended in current guidelines.

Study design

  • Primary cohort: 4724 patients from Flatiron Health database with metastatic nonsquamous NSCLC received first-line carboplatin/pemetrexed with (n=1965) or without (n=2759) bevacizumab.
  • Secondary analysis: 539 patients from the University of Pennsylvania with metastatic nonsquamous NSCLC were treated with first-line carboplatin/pemetrexed with (n=204) or without (n=335) bevacizumab.
  • Funding: None disclosed.

Key results

  • Median OS was longer in the primary (12.1 vs 8.6 months) and secondary (18.0 vs 10.0 months) cohorts.
  • After multivariable analysis, bevacizumab was associated with significantly better OS in the primary (aHR, 0.80; 95% CI, 0.75-0.86) and secondary (aHR, 0.75; 95% CI, 0.59-0.96) cohorts.
  • Bevacizumab was associated with better OS in patients aged ≥65 years (HR, 0.80; 95% CI, 0.73-0.88) and those aged ≥75 years (HR, 0.77; 95% CI, 0.67-0.89).

Limitations

  • Retrospective study.

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