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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