Lung Cancer. 2012 Sep 22. pii: S0169-5002(12)00486-2. doi: 10.1016/j.lungcan.2012.08.017. [Epub ahead of print]
Bevacizumab and erlotinib (BE) first-line therapy in advanced non-squamous non-small-cell lung cancer (NSCLC) (stage IIIB/IV) followed by platinum-based chemotherapy (CT) at disease progression: A multicenter phase II trial (SAKK 19/05)
Francesco Z, Cornelia D, Daniel B, Roger VM, Lukas B, Adrian O, Oliver G, Elisabeth OL, Patrizia F, Rolf S, Thomas H, Daniel R, Petra S, Michael M, Susanne C, Peter B, Karin R, Miklos P; on behalf of the Swiss Group for Clinical Cancer Research (SAKK)..
Source
Oncology Institute of Southern Switzerland, Switzerland. Electronic address: francesco.zappa@clinicaluganese.ch.
Abstract
PURPOSE:
This phase II trial aimed to evaluate feasibility and efficacy of a first-line combination of targeted therapies for advanced non-squamous NSCLC: bevacizumab (B) and erlotinib (E), followed by platinum-based CT at disease progression (PD).
METHODS:
103 patients with advanced non-squamous NSCLC were treated with B (15mg/kg day 1 of each 21-day cycle) and E (150mg daily) until PD or unacceptable toxicity. Upon PD patients received 6 cycles of CT (cisplatin/carboplatin and gemcitabine). The primary endpoint was disease stabilization rate (DSR) after 12 weeks of BE treatment.
RESULTS:
101 patients were evaluable. Under BE, DSR at week 12 was 54.5%. 73 patients had at least stable disease (SD), including 1 complete remission and 17 partial responses (PR). No unexpected toxicities were observed. Median time to progression (TTP) under BE was 4.1 months. 62 patients started CT; 35 received at least 4 cycles (6 PR, 32 SD). At a median follow-up of 36 months, median overall survival (OS) was 14.1 months.
CONCLUSIONS:
First-line BE treatment followed by a fixed CT regimen at PD is feasible with acceptable toxicity and activity. In a non-squamous NSCLC population unselected for EGFR status, we found OS rates similar to standard CT.
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