Complexo Hospitalario Universitario de Santiago, Medical Oncology Department, Travesía da Choupana, s/n, 15706 Santiago de Compostela, Spain.
Expert Opin Pharmacother. 2012 Jul;13(10):1389-96. doi: 10.1517/14656566.2012.693165. Epub 2012 May 25.
The aim of this study was to evaluate efficacy and safety of first-line treatment with bevacizumab, cisplatin and vinorelbine and bevacizumab maintenance in non-squamous, non-small cell lung cancer (NSCLC).
Forty-nine patients with stage IIIB plus pleural effusion or stage IV NSCLC were included in a Phase II clinical trial. Treatment consisted of 3-week cycles of bevacizumab (15 mg/kg on day 1), cisplatin (80 mg/m(2) on day 1) and vinorelbine (25 mg/m(2) on days 1 and 8). After 6 cycles, non-progressing patients received bevacizumab maintenance therapy. The primary end point was progression-free survival (PFS), calculated using the Kaplan-Meier method.
Thirteen (29%) of 45 evaluable patients presented a partial response. PFS and overall survival were 6.0 months (95% confidence interval (CI) 4.5 - 7.5) and 14.7 months (95% CI 8.4 - 21), respectively. Fourteen patients (28%) experienced grade 3 - 4 neutropenia and 7 (14%) experienced febrile neutropenia during the combination treatment. During the maintenance phase, the most frequent grade 3 - 4 adverse event was hypertension. Neither grade 3 - 4 thrombocytopenia nor toxic death was observed.
The studied regimen achieved a similar efficacy to other regimens containing platinum doublets. The data provide further evidence that bevacizumab may be used in combination with multiple standard platinum-based doublets in this setting.
本研究旨在评估贝伐珠单抗联合顺铂和长春瑞滨一线治疗及贝伐珠单抗维持治疗非鳞状非小细胞肺癌(NSCLC)的疗效和安全性。
49 例 IIIB 期伴胸腔积液或 IV 期 NSCLC 患者入组进行 II 期临床试验。治疗方案为 3 周周期的贝伐珠单抗(第 1 天 15mg/kg)、顺铂(第 1 天 80mg/m²)和长春瑞滨(第 1 和 8 天 25mg/m²)。6 个周期后,无进展患者接受贝伐珠单抗维持治疗。主要终点为无进展生存期(PFS),采用 Kaplan-Meier 法计算。
45 例可评估患者中有 13 例(29%)出现部分缓解。PFS 和总生存期分别为 6.0 个月(95%置信区间 4.5-7.5)和 14.7 个月(95%置信区间 8.4-21)。14 例患者(28%)发生 3-4 级中性粒细胞减少症,7 例患者(14%)发生发热性中性粒细胞减少症。在维持治疗阶段,最常见的 3-4 级不良事件是高血压。未观察到 3-4 级血小板减少症或毒性死亡。
该方案的疗效与其他含铂双药方案相似。该数据进一步证明,贝伐珠单抗可与多种标准铂类双药联合用于该治疗环境。