OBJECTIVES: Bevacizumab with chemotherapy improved overall survival (OS) in the E4599 trial in metastatic nonsquamous non-small cell lung cancer (NS-NSCLC). A meta-analysis demonstrated an OS benefit with bevacizumab only in a subset of nonwhite patients. We explored the efficacy of antivascular endothelial growth factor antibodies (AVA) in a diverse cohort. MATERIALS AND METHODS: Patients with advanced (stage IIIB/IV, American Joint Committee Cancer 7th edition) recurrent or metastatic NS-NSCLC diagnosed January 2006 to December 2017 at a single medical center were included. Survival analysis was performed with log-rank testing of the Kaplan-Meier estimator. Univariate models were constructed, and significant variables, age, sex, race were incorporated into a multivariate Cox proportional hazard model. Data analysis was performed on SAS. RESULTS: A total of 171 patients, 80 were treated with AVA and 91 were untreated. Median age: 63 years, 55% females, 19% non-Hispanic whites, 44% blacks and 32% Hispanic whites; median 40 pack-years of smoking; 11.7% had sensitizing epidermal growth factor receptor mutations. Patients who received AVA had a survival benefit (26.6 vs. 19 mo, P=0.025). Adjusting for age, sex, race/ethnicity, epidermal growth factor receptor mutations, Eastern Cooperative Oncology Group performance status and number of metastases; AVA therapy was associated with improved OS (adjusted hazard ratio=0.62; P=0.049). In a subgroup analysis, females had survival benefit with AVA (median survival: 29.1 vs. 14.2 mo, log-rank P=0.02) which was significant in the adjusted model (adjusted hazard ratio=0.52; P=0.049). CONCLUSIONS: In a diverse cohort of patients with advanced NS-NSCLC, a survival benefit was confirmed with AVA. The greatest magnitude of benefit was in blacks and non-Hispanic whites. A significant survival benefit was limited to female patients.
OBJECTIVES: Bevacizumab with chemotherapy improved overall survival (OS) in the E4599 trial in metastatic nonsquamous non-small cell lung cancer (NS-NSCLC). A meta-analysis demonstrated an OS benefit with bevacizumab only in a subset of nonwhite patients. We explored the efficacy of antivascular endothelial growth factor antibodies (AVA) in a diverse cohort. MATERIALS AND METHODS: Patients with advanced (stage IIIB/IV, American Joint Committee Cancer 7th edition) recurrent or metastatic NS-NSCLC diagnosed January 2006 to December 2017 at a single medical center were included. Survival analysis was performed with log-rank testing of the Kaplan-Meier estimator. Univariate models were constructed, and significant variables, age, sex, race were incorporated into a multivariate Cox proportional hazard model. Data analysis was performed on SAS. RESULTS: A total of 171 patients, 80 were treated with AVA and 91 were untreated. Median age: 63 years, 55% females, 19% non-Hispanic whites, 44% blacks and 32% Hispanic whites; median 40 pack-years of smoking; 11.7% had sensitizing epidermal growth factor receptor mutations. Patients who received AVA had a survival benefit (26.6 vs. 19 mo, P=0.025). Adjusting for age, sex, race/ethnicity, epidermal growth factor receptor mutations, Eastern Cooperative Oncology Group performance status and number of metastases; AVA therapy was associated with improved OS (adjusted hazard ratio=0.62; P=0.049). In a subgroup analysis, females had survival benefit with AVA (median survival: 29.1 vs. 14.2 mo, log-rank P=0.02) which was significant in the adjusted model (adjusted hazard ratio=0.52; P=0.049). CONCLUSIONS: In a diverse cohort of patients with advanced NS-NSCLC, a survival benefit was confirmed with AVA. The greatest magnitude of benefit was in blacks and non-Hispanic whites. A significant survival benefit was limited to female patients.
Authors: Krishnansu S Tewari; Michael W Sill; Richard T Penson; Helen Huang; Lois M Ramondetta; Lisa M Landrum; Ana Oaknin; Thomas J Reid; Mario M Leitao; Helen E Michael; Philip J DiSaia; Larry J Copeland; William T Creasman; Frederick B Stehman; Mark F Brady; Robert A Burger; J Tate Thigpen; Michael J Birrer; Steven E Waggoner; David H Moore; Katherine Y Look; Wui-Jin Koh; Bradley J Monk Journal: Lancet Date: 2017-07-27 Impact factor: 79.321
Authors: Brian I Rini; Thomas Powles; Michael B Atkins; Bernard Escudier; David F McDermott; Cristina Suarez; Sergio Bracarda; Walter M Stadler; Frede Donskov; Jae Lyun Lee; Robert Hawkins; Alain Ravaud; Boris Alekseev; Michael Staehler; Motohide Uemura; Ugo De Giorgi; Begoña Mellado; Camillo Porta; Bohuslav Melichar; Howard Gurney; Jens Bedke; Toni K Choueiri; Francis Parnis; Tarik Khaznadar; Alpa Thobhani; Shi Li; Elisabeth Piault-Louis; Gretchen Frantz; Mahrukh Huseni; Christina Schiff; Marjorie C Green; Robert J Motzer Journal: Lancet Date: 2019-05-09 Impact factor: 79.321
Authors: Edward B Garon; Tudor-Eliade Ciuleanu; Oscar Arrieta; Kumar Prabhash; Konstantinos N Syrigos; Tuncay Goksel; Keunchil Park; Vera Gorbunova; Ruben Dario Kowalyszyn; Joanna Pikiel; Grzegorz Czyzewicz; Sergey V Orlov; Conrad R Lewanski; Michael Thomas; Paolo Bidoli; Shaker Dakhil; Steven Gans; Joo-Hang Kim; Alexandru Grigorescu; Nina Karaseva; Martin Reck; Federico Cappuzzo; Ekaterine Alexandris; Andreas Sashegyi; Sergey Yurasov; Maurice Pérol Journal: Lancet Date: 2014-06-02 Impact factor: 79.321
Authors: Martin Reck; Joachim von Pawel; Petr Zatloukal; Rodryg Ramlau; Vera Gorbounova; Vera Hirsh; Natasha Leighl; Jörg Mezger; Venice Archer; Nicola Moore; Christian Manegold Journal: J Clin Oncol Date: 2009-02-02 Impact factor: 44.544
Authors: Fabio Conforti; Laura Pala; Vincenzo Bagnardi; Tommaso De Pas; Marco Martinetti; Giuseppe Viale; Richard D Gelber; Aron Goldhirsch Journal: Lancet Oncol Date: 2018-05-16 Impact factor: 41.316
Authors: J-C Soria; A Mauguen; M Reck; A B Sandler; N Saijo; D H Johnson; D Burcoveanu; M Fukuoka; B Besse; J-P Pignon Journal: Ann Oncol Date: 2012-11-23 Impact factor: 32.976