NSCLC: no benefit for combining maintenance pemetrexed, bevacizumab

  • Ramalingam SS & al.
  • J Clin Oncol
  • 30 Jul 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Combining pemetrexed and bevacizumab maintenance therapy increased toxicity with no survival benefit over either drug alone in patients with advanced nonsquamous NSCLC.
  • Single-agent maintenance therapy was optimal in this randomized trial.

Why this matters

  • National guidelines recommend pemetrexed, bevacizumab, or their combination as maintenance therapy, the latter based on previous research suggesting PFS benefit.

Study design

  • Multicenter phase 3 ECOG-ACRIN 5508 trial.
  • 874 patients with advanced nonsquamous NSCLC and no progression after first-line combination chemotherapy were randomly assigned to maintenance pemetrexed (n=294), bevacizumab (n=287), or both (n=293).
  • Median follow-up, 50.6 months.
  • Funding: National Cancer Institute.

Key results

  • No significant difference in median OS between pemetrexed and bevacizumab (15.9 vs 14.4 months; P=.12) or combination therapy vs bevacizumab (16.4 vs 14.14 months; P=.28).
  • No significant difference in median PFS between pemetrexed and bevacizumab (5.1 vs 4.2 months; P=.06) or, after multivariate analysis, between combination therapy and bevacizumab (7.5 vs 4.2 months; P=.22).
  • The combination group had greater grade 3-5 toxicity rates vs bevacizumab and pemetrexed (51% vs 30% vs 38%).

Limitations

  • None included.

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit