1. Bevacizumab plus chemotherapy for patients with advanced pulmonary adenocarcinoma harboring <italic>EGFR</italic> mutations.
- Author
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Chen, R.-L., Chen, H.-J., Jiang, B.-Y., Zhang, X.-C., Zhou, Q., Tu, H.-Y., Zhong, W.-Z., Wu, Y.-L., and Yang, J.-J.
- Abstract
Purpose: Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) and bevacizumab plus chemotherapy were effective for
EGFR -mutant patients. However, the appropriated treatment orders remained controvertible. We investigated the efficacy of treatment orders between bevacizumab plus chemotherapy and EGFR-TKIs forEGFR -mutant patients with advanced pulmonary adenocarcinoma.Patients and methods: This study involved 40EGFR -mutant patients with advanced pulmonary adenocarcinoma who were treated with bevacizumab plus carboplatin and paclitaxel (Bev + CP) and EGFR-TKIs in different treatment orders or gemcitabine plus cisplatin (GP) in first-line setting. Seventeen patients were treated with Bev + CP and 10 cases with GP in first-line treatment. Thirteen patients received EGFR-TKIs after first-line Bev + CP regimen, while 13 patients were treated with first-line EGFR-TKIs. Progression-free survival (PFS), the response rate (ORR) and overall survival (OS) were evaluated.Results: Median PFS of Bev + CP treatment was significantly longer in first-line than non-first-line settings (11.7 vs. 5.6 months,P = 0.003). Median OS was 37.8 months forEGFR -mutant patients with first-line Bev + CP followed by second-line EGFR-TKIs and 31.0 months for those with first-line EGFR-TKIs and non-first-line Bev + CP, respectively (P = 0.509). Median PFS was 11.7 (95% CI 10.6–12.8) months for Bev + CP group and 4.7 (95% CI 4.4–5.0) months for GP group with the hazard ratio of 0.17 (P = 0.001). ORR was 70.6 and 50.0% in the two groups, respectively (P = 0.415). However, there was no significant difference in median OS (33.7 vs 27.8 months,P = 0.293).Conclusions: First-line Bev + CP followed by EGFR-TKIs might possibly provide favorable prognosis forEGFR -mutant patients. Bev + CP regimen significantly prolonged PFS in first-line than non-first-line settings. These findings warrant further investigations. [ABSTRACT FROM AUTHOR]- Published
- 2018
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