BACKGROUND: Bevacizumab improves responses and progression-free survival when added to first-line paclitaxel/carboplatin or cisplatin/gemcitabine for patients with advanced nonsquamous non-small cell lung cancer. This study was designed to evaluate toxicities and efficacy of gemcitabine/carboplatin/bevacizumab. METHODS: Patients with untreated advanced nonsquamous non-small cell lung cancer, with no evidence of brain metastases and not on anticoagulation were eligible. Patients received gemcitabine 1000 mg/m on days 1 and 8; carboplatin area under the curve 5 day 1; and bevacizumab 15 mg/kg day 1 every 3 weeks for up to six cycles. Bevacizumab was then continued every 3 weeks until disease progression or unacceptable toxicity. RESULTS: From July 2006 to December 2008, 48 patients were enrolled: 23 (48%) men, 25 (52%) women, and 19 (40%) never smokers. One patient never received therapy and is not included in the analysis. Median cycle number was 8 (1-42) with 37 patients (78.7%) completing ≥4 cycles of three drugs. Dose reductions occurred in 34 (72.3%) patients. Grade 3/4 toxicities included neutropenia (47%/15%), thrombocytopenia (11%/15%), anemia (6%/0%), dyspnea (6%/2%), bacterial pneumonia (4%/0%), and hypertension (4%/2%). No neutropenic fevers occurred. One patient died of hemoptysis. Grade 3 bleeding occurred in three other patients. There were seven (14.9%) partial responses. Median time to first event (progression/death/toxicity requiring discontinuation) was 6.4 months (95% confidence interval: 4.8-7.9 months). The median overall survival (OS) was 12.8 months (95% confidence interval: 10.0-16.5). The OS is 57% at 1 year and 10% at 2 years. CONCLUSIONS: Although perhaps skewed by a high proportion of nonsmokers and women, treatment with gemcitabine/carboplatin/bevacizumab has an acceptable toxicity profile with promising median OS despite a low response rate.
BACKGROUND:Bevacizumab improves responses and progression-free survival when added to first-line paclitaxel/carboplatin or cisplatin/gemcitabine for patients with advanced nonsquamous non-small cell lung cancer. This study was designed to evaluate toxicities and efficacy of gemcitabine/carboplatin/bevacizumab. METHODS:Patients with untreated advanced nonsquamous non-small cell lung cancer, with no evidence of brain metastases and not on anticoagulation were eligible. Patients received gemcitabine 1000 mg/m on days 1 and 8; carboplatin area under the curve 5 day 1; and bevacizumab 15 mg/kg day 1 every 3 weeks for up to six cycles. Bevacizumab was then continued every 3 weeks until disease progression or unacceptable toxicity. RESULTS: From July 2006 to December 2008, 48 patients were enrolled: 23 (48%) men, 25 (52%) women, and 19 (40%) never smokers. One patient never received therapy and is not included in the analysis. Median cycle number was 8 (1-42) with 37 patients (78.7%) completing ≥4 cycles of three drugs. Dose reductions occurred in 34 (72.3%) patients. Grade 3/4 toxicities included neutropenia (47%/15%), thrombocytopenia (11%/15%), anemia (6%/0%), dyspnea (6%/2%), bacterial pneumonia (4%/0%), and hypertension (4%/2%). No neutropenic fevers occurred. One patient died of hemoptysis. Grade 3 bleeding occurred in three other patients. There were seven (14.9%) partial responses. Median time to first event (progression/death/toxicity requiring discontinuation) was 6.4 months (95% confidence interval: 4.8-7.9 months). The median overall survival (OS) was 12.8 months (95% confidence interval: 10.0-16.5). The OS is 57% at 1 year and 10% at 2 years. CONCLUSIONS: Although perhaps skewed by a high proportion of nonsmokers and women, treatment with gemcitabine/carboplatin/bevacizumab has an acceptable toxicity profile with promising median OS despite a low response rate.
Authors: Joseph Treat; Martin J Edelman; Chandra P Belani; Mark A Socinski; Matthew J Monberg; Ruqin Chen; Coleman K Obasaju Journal: Lung Cancer Date: 2010-03-27 Impact factor: 5.705
Authors: Joan H Schiller; David Harrington; Chandra P Belani; Corey Langer; Alan Sandler; James Krook; Junming Zhu; David H Johnson Journal: N Engl J Med Date: 2002-01-10 Impact factor: 91.245
Authors: T Le Chevalier; G Scagliotti; R Natale; S Danson; R Rosell; R Stahel; P Thomas; R M Rudd; J Vansteenkiste; N Thatcher; C Manegold; J-L Pujol; N van Zandwijk; C Gridelli; J P van Meerbeeck; L Crino; A Brown; P Fitzgerald; M Aristides; J H Schiller Journal: Lung Cancer Date: 2005-01 Impact factor: 5.705
Authors: U Gatzemeier; F A Shepherd; T Le Chevalier; P Weynants; B Cottier; H J Groen; R Rosso; K Mattson; H Cortes-Funes; M Tonato; R L Burkes; M Gottfried; M Voi Journal: Eur J Cancer Date: 1996-02 Impact factor: 9.162
Authors: M Reck; J von Pawel; P Zatloukal; R Ramlau; V Gorbounova; V Hirsh; N Leighl; J Mezger; V Archer; N Moore; C Manegold Journal: Ann Oncol Date: 2010-02-11 Impact factor: 32.976
Authors: Jyoti D Patel; Thomas A Hensing; Alfred Rademaker; Eric M Hart; Matthew G Blum; Daniel T Milton; Philip D Bonomi Journal: J Clin Oncol Date: 2009-05-11 Impact factor: 44.544
Authors: E Bajetta; S C Stani; D De Candis; N Zaffaroni; N Zilembo; D Cortinovis; S Aglione; L Mariani; B Formisano; P Bidoli Journal: Ann Oncol Date: 2003-02 Impact factor: 32.976
Authors: Christopher M Tully; Andrea B Apolo; Emily C Zabor; Ashley M Regazzi; Irina Ostrovnaya; Helena F Furberg; Jonathan E Rosenberg; Dean F Bajorin Journal: Cancer Date: 2015-11-30 Impact factor: 6.860