NSCLC with brain metastases: adding bevacizumab to EGFR-TKIs improves survival

  • Jiang T & al.
  • Eur J Cancer
  • 1 Nov 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • First-line bevacizumab plus epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) offered better OS, PFS, and objective response rates (ORRs) than EGFR-TKIs alone in patients with EGFR-mutant advanced nonsquamous NSCLC and multiple brain metastases.

Why this matters

  • Brain metastasis is one of the most common distant metastases in patients with advanced NSCLC.

Study design

  • 208 patients with EGFR-mutant advanced nonsquamous NSCLC and multiple brain metastases received EGFR-TKIs either alone (n=149) or with bevacizumab (n=59).
  • Funding: National Natural Science Foundation of China.

Key results

  • Combination therapy offered significantly better OS (29.6 vs 21.7 months; HR, 0.51; P<.001 intracranial orr vs p=".001)," systemic pfs months hr and>
  • Outcomes were similar regardless of patients’ specific EGFR mutations.
  • After multivariable analysis, combination therapy was associated with better intracranial PFS (HR, 0.546; P<.001 systemic pfs p and os>
  • The combination group had more grade ≥3 adverse events (84.7% vs 57.0%), with the most common including hypertension, proteinuria, rash, and liver function disorder or abnormal hepatic function.

Limitations

  • Retrospective study.