Addition of Bevacizumab Improves Overall Survival in Mesothelioma
Addition of bevacizumab to pemetrexed plus cisplatin may significantly improve overall survival in patients with malignant pleural mesothelioma.
Addition of bevacizumab to pemetrexed plus cisplatin may significantly improve overall survival in patients with malignant pleural mesothelioma, according to a study published in The Lancet.
However, patients are at higher risk of manageable toxic effects.
Researchers led by Gérard Zalcman, MD, PhD, of the University of Caen in France conducted a randomized, controlled, open-label, phase 3 trial of 448 patients with unresectable malignant pleural mesothelioma who had received previous chemotherapy and had an Eastern Cooperative Oncology Group performance status of 0 to 2.
From February 2008 to January 2014, patients received either pemetrexed plus cisplatin with or without bevacizumab in 21-day cycles for up to 6 cycles. Primary outcome was overall survival in the intention-to-treat population.
The researchers found that overall survival was significantly longer with the addition of bevacizumab at a median of 19.8 months compared with 16.1 months without bevacizumab.
In addition, 158 of the 222 patients (71%) who received bevacizumab had grade 3 to 4 adverse events compared to 139 of 224 patients (62%) who had not received bevacizumab. There were more grade 3 or higher hypertension and thrombotic events in the group that received bevacizumab.
The authors concluded that addition of bevacizumab to pemetrexed and cisplatin “should be considered as a suitable treatment for the disease.”
- Zalcman G, Mazieres J, Margery J, et al. Bevacizumab for newly diagnosed pleural mesothelioma in the Mesothelioma Avastin Cisplatin Pemetrexed Study (MAPS): a randomised, controlled, open-label, phase 3 trial [published online ahead of print December 21, 2015]. The Lancet. doi: http://dx.doi.org/10.1016/S0140-6736(15)01238-6.