NSCLC: better PFS with weekly paclitaxel plus bevacizumab

  • Cortot AB & al.
  • Eur J Cancer
  • 7 Apr 2020

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Patients with advanced nonsquamous NSCLC who received weekly paclitaxel plus bevacizumab (wPAC-BEV) as second- or third-line therapy had a better PFS and objective response rate (ORR) than those who received docetaxel in this phase 3 trial.

Why this matters

  • Bevacizumab, which is approved in Europe and the United States as first-line therapy with chemotherapy for nonsquamous NSCLC, combined with weekly paclitaxel, has yielded positive outcomes in patients with metastatic breast cancer.

Study design

  • Double-group, randomized, open-label, multicenter, phase 3 clinical trial.
  • 166 patients with previously treated advanced nonsquamous NSCLC received wPAC-BEV (n=111) or docetaxel (n=55).
  • Funding: Roche.

Key results

  • PFS was significantly better with wPAC-BEV (5.4 vs 3.9 months; adjusted HR, 0.61; P=.005).
  • Patients with fewer prior bevacizumab cycles had better PFS benefit from wPAC-BEV.
  • ORR at 8 weeks was significantly better with wPAC-BEV (22.5% vs 5.5%; P=.006).
  • OS was not significantly different between groups at a median follow-up of 36.2 months.
  • Rate of grade 3-4 treatment-related adverse events was similar between groups (45.9% with wPAC-BEV vs 54.5% with docetaxel).
  • But overall treatment-related adverse events were more frequent with wPAC-BEV (98.2% vs 90.2%).

Limitations

  • The docetaxel group included more older patients and never-smokers.