Zarza V, Couraud S, Bosc C, Toffart A-C, Moro-Sibilot D, Souquet P-J
Service de pneumologie et oncologie thoracique, hospices civils de Lyon, CH Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France; Faculté de médecine et de maïeutique Lyon-Sud - Charles-Mérieux, université Lyon-1, 69600 Oullins, France.
Service de pneumologie et oncologie thoracique, hospices civils de Lyon, CH Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France; Faculté de médecine et de maïeutique Lyon-Sud - Charles-Mérieux, université Lyon-1, 69600 Oullins, France.
Rev Mal Respir. 2014 Sep;31(7):601-7. doi: 10.1016/j.rmr.2013.05.011. Epub 2013 Nov 9.
Bevacizumab is recommended in first line chemotherapy for advanced non-squamous non-small cell lung cancer (NSCLC). Paclitaxel is a doublet drug also widely used in cisplatin-based regimens. Paclitaxel plus bevacizumab is a standard regimen as first line treatment of metastatic breast cancer. Since there is no guideline for third line treatment of NSCLC, some oncology units use paclitaxel-bevacizumab in some NSCLC patient after relapse of the second line. The aim of this study was to assess retrospectively the feasibility and efficacy of this treatment option in stage IV NSCLC.
Patients who had received the combination of paclitaxel (80 to 90 mg/m(2) in a weekly schedule) and bevacizumab (7.5 to 15 mg/kg every 21 days) in the thoracic oncology departments of two university hospitals in the Rhone-Alpes Department were retrospectively reviewed.
Twelve patients underwent this treatment. Their mean age was 56 years and their performance status was less or equal to 1 in 50 % of the cases. The chemotherapy was given as fifth line in 67 % of the patients and 67 % were antiangiogenic naïve. They received a mean of 6 courses. The overall response rate was 33 % and the disease control rate 66 %. Median progression-free survival was 5.1 months (95 %CI 1.0-9.1). Ten patients (82 %) experienced toxicity, the majority grade 1 to 2 events, and only one a grade 3 event (febrile neutropenia). There were no severe bleeding episodes.
Combined paclitaxel-bevacizumab chemotherapy seems feasible in patients with NSCLC. The toxicity profile is acceptable. This regimen should be evaluated in further prospective studies.
贝伐单抗被推荐用于晚期非鳞状非小细胞肺癌（NSCLC）的一线化疗。紫杉醇是一种双联药物，也广泛用于基于顺铂的治疗方案。紫杉醇联合贝伐单抗是转移性乳腺癌一线治疗的标准方案。由于尚无NSCLC三线治疗的指南，一些肿瘤科室在部分NSCLC患者二线复发后使用紫杉醇 - 贝伐单抗治疗。本研究的目的是回顾性评估该治疗方案在IV期NSCLC中的可行性和疗效。
回顾性分析法国罗纳 - 阿尔卑斯大区两家大学医院胸肿瘤科接受紫杉醇（每周80至90 mg/m²）联合贝伐单抗（每21天7.5至15 mg/kg）治疗的患者。
12例患者接受了该治疗。他们的平均年龄为56岁，50%的患者体力状况评分为0或1分。67%的患者化疗为第五线治疗，67%的患者之前未接受过抗血管生成治疗。他们平均接受了6个疗程的治疗。总缓解率为33%，疾病控制率为66%。中位无进展生存期为5.1个月（95%CI 1.0 - 9.1）。10例患者（82%）出现毒性反应，大多数为1至2级事件，仅1例为3级事件（发热性中性粒细胞减少）。无严重出血事件发生。
紫杉醇 - 贝伐单抗联合化疗在NSCLC患者中似乎可行。毒性反应可接受。该方案应在进一步的前瞻性研究中进行评估。
