PPB Regimen Feasible as Initial Therapy for Fit Patients With NSCLC

Paclitaxel and pemetrexed with bevacizumab produced a high response rate as initial therapy in advanced lung adenocarcinomas.
Paclitaxel and pemetrexed with bevacizumab produced a high response rate as initial therapy in advanced lung adenocarcinomas.

Paclitaxel and pemetrexed with bevacizumab (PPB) produced a high response rate as initial therapy in treatment-naïve patients with advanced lung adenocarcinomas, a study published in the Journal of Thoracic Oncology has shown.1

For the phase 2 trial, researchers enrolled 44 patients with untreated, advanced lung adenocarcinomas with measurable disease. Participants received paclitaxel 90 mg/m2 IV, pemetrexed 500 mg/m2 IV, and bevacizumab 10 mg/kg IV every 14 days for 6 months; followed by, pemetrexed and bevacizumab every 14 days until disease progression or unacceptable toxicity.

Results showed that 52% (95% CI: 37-68) achieved a partial response, including 7 of the 16 patients harboring KRAS mutations. Researchers found that the 2-year overall survival rate was 43% and median survival was 17 months (95% CI: 10-29).

In terms of safety, the most common grade 3 or 4 treatment-related toxicities included elevated ALT (16%), fatigue (16%), leukopenia (9%), anemia (7%), and elevated AST (7%). Five percent of patients experienced grade 3 or 4 edema and pleural effusions each.

Of note, 2 patients died due to respiratory failure without disease progression.

These survival and safety findings were comparable to previously reported phase 2 studies that assessed platinum-containing doublets in combination with bevacizumab.

“These results justify use of the paclitaxel, pemetrexed, and bevacizumab regimen in fit patients where 3-drug regimens including bevacizumab are appropriate,” the authors conclude.

REFERENCE

1. Pietanza CM, Hellmann MD, Fiore JJ, et al. Phase II study of a non-platinum-containing doublet of paclitaxel and pemetrexed with bevacizumab (PPB) as initial therapy for patients with advanced lung adenocarcinomas [published online ahead of print March 7, 2016]. J Thorac Oncol. doi:10.1016/j.jtho.2016.02.018.

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