Bevacizumab Not Recommended as Adjuvant Therapy in NSCLC

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Investigators randomly assigned 1501 patients with completely resected stage IB to IIIA NSCLC to receive chemotherapy alone or chemotherapy plus bevacizumab.
Investigators randomly assigned 1501 patients with completely resected stage IB to IIIA NSCLC to receive chemotherapy alone or chemotherapy plus bevacizumab.

Bevacizumab does not improve overall survival (OS) among patients with resected early-stage non–small cell lung cancer (NSCLC) when added to adjuvant chemotherapy, according to a study published in Lancet Oncology.1

Evidence from a previous study suggested that adding bevacizumab to platinum doublet chemotherapy improved survival outcomes for patients with advanced NSCLC.

For this open-label phase 3 study (ClinicalTrials.gov Identifier: NCT00324805), investigators randomly assigned 1501 patients with completely resected stage IB to IIIA NSCLC to receive chemotherapy alone (Group A) or chemotherapy plus bevacizumab (Group B). Chemotherapy regimens included cisplatin plus investigator's choice of docetaxel, gemcitabine, pemetrexed, or vinorelbine.

After median follow-up of 50.3 months, the estimated median OS for patients in Group A had not been reached compared with 85.8 months (95% CI, 74.9-not evaluable) in Group B (hazard ratio [HR], 0.99; 95% CI, 0.82-1.19; P = .90).

Patients in Group B had overall higher grade and rates of adverse events compared with Group A; 67% of patients in Group A and 83% of patients in Group B reported grade 3 to 5 toxicities, including hypertension and neutropenia.

As bevacizumab did not demonstrate any survival benefit, the authors concluded that “[t]he overall outcomes of this trial did show improvement in overall survival compared with historical controls, which is indicative of other improvements in lung cancer outcomes for patients with resected early-stage NSCLC.”

Reference

  1. Wakelee HA, Dahlberg SE, Keller SM, et al. Adjuvant chemotherapy with or without bevacizumab in patients with resected non-small-cell lung cancer (E1505): an open-label, multicentre, randomised, phase 3 trial. Lancet Oncol. 2017 Nov 9. doi: 10.1016/S1470-2045(17)30691-5 [Epub ahead of print]

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