Addition of Bevacizumab to Chemo Improves PFS in Extensive SCLC

Bevacizumab in combination with cisplatin and etoposide has proved efficacious in extensive-disease SCLC.
Bevacizumab in combination with cisplatin and etoposide has proved efficacious in extensive-disease SCLC.

The addition of bevacizumab to first-line treatment with cisplatin plus etoposide significantly improved progression-free survival, but not overall survival, with an acceptable toxicity profile in patients with extensive-disease small-cell lung cancer (SCLC), a study published in the Journal of Clinical Oncology has shown.1

Phase 2 studies have demonstrated encouraging efficacy with bevacizumab in combination with cisplatin and etoposide in extensive-disease SCLC. Therefore, researchers sought to evaluate the efficacy of adding bevacizumab to cisplatin and etoposide in the first-line treatment of this population in a phase 3 trial.

For the study, investigators enrolled 204 treatment-naive patients with extensive-disease SCLC and randomly assigned them 1:1 to receive cisplatin plus etoposide with or without bevacizumab for up to 6 cycles. Patients receiving bevacizumab who did not experience disease progression continued bevacizumab alone until disease progression or for a maximum of 18 cycles.

At a median follow-up of 34.9 months, results showed that treatment with bevacizumab was associated with a significant improvement in progression-free survival compared with chemotherapy alone (P = .030); median progression-free survival was 6.7 months and 5.7 months, respectively.

However, researchers found no significant difference in the risk of death between the 2 treatment arms (hazard ratio [HR], 0.78; 95% CI, 0.58-1.06; P = .113). Median overall survival was 8.9 months with cisplatin plus etoposide vs 9.8 months with chemotherapy plus bevacizumab; 1-year survival rates were 25% and 37%, respectively.

Investigators observed a significant survival benefit in patients who received maintenance bevacizumab (HR, 0.60; 95% CI, 0.40-0.91; P = .011).

There were no statistically significant differences in the rates of hematologic toxicities between the arms, but hypertension was significantly more frequent in the bevacizumab arm (P = .057).

Although treatment with bevacizumab added no apparent survival advantage, the finding that adding immunotherapy improved progression-free survival suggests that further studies with novel and better antiangiogenic agents in extensive-disease SCLC are warranted.

Reference

1. Tiseo M, Boni L, Ambrosio F, et al. Italian, multicenter, phase III, randomized study of cisplatin plus etoposide with or without bevacizumab as first-line treatment in extensive-disease small-cell lung cancer: The GOIRC-AIFA FARM6PMFJM trial. J Clin Oncol. 2017 Jan 30. doi: 10.1200/JCO.2016.69.4844 [Epub ahead of print]

You must be a registered member of ONA to post a comment.

Sign Up for Free e-newsletters

Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Genitourinary Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Rare Cancers Regimens
Skin Cancer Regimens Drugs