Ding Lingyu, Liu Kejun, Jiang Zhelong, Chen Qi, Zhou Ningning, Liang Ying, Gao Hongfei, Hong Xiangchan, Wu Haiying
Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Tumour Biol. 2015 Apr;36(4):2491-9. doi: 10.1007/s13277-014-2862-4. Epub 2014 Nov 25.
Bevacizumab (Bev), a monoclonal antibody against vascular endothelial growth factor, when combined with standard first-line chemotherapy, shows impressive clinical benefit in advanced non-squamous non-small cell lung cancer (ns-NSCLC). Our study aims to investigate whether the addition of Bev to pemetrexed improves progression-free survival (PFS) in advanced ns-NSCLC patients after the failure of at least one prior chemotherapy regimens. Patients with locally advanced, recurrent, or metastatic ns-NSCLC, after failure of platinum-based therapy, with a performance status 0 to 2, were eligible. Patients received 500 mg/m(2) of pemetrexed intravenously (IV) day 1 with vitamin B12, folic acid, and dexamethasone and Bev 7.5 mg/kg IV day 1 of a 21-day cycle until unacceptable toxicity, disease progression or the patient requested therapy discontinuation. The primary end point was PFS. Between December 2011 and October 2013, 33 patients were enrolled, with median age of 55 years and 36.4% men. Twenty-three patients (69.7%) had received two or more prior regimens, and 28 patients (84.8%) had received chemotherapy containing pemetrexed. The median number of the protocol regimens was 4. Median PFS was 4.37 months (95% CI 2.64-6.09 months). Median overall survival (OS) was 15.83 months (95% CI 10.52-21.15 months). Overall response rates were 6.45%. Disease control rate was 54.84%. No new safety signals were detected. No patient experienced drug-related deaths. The combination of Bev and pemetrexed every 21 days is effective in ns-NSCLC patients who failed of prior therapies with improved PFS. Toxicities are similar with historical data of these two agents and are tolerable. Our results may provide more a regimen containing Bev and pemetrexed for Chinese clinical practice in previously treated ns-NSCLC.
贝伐单抗(Bev)是一种抗血管内皮生长因子的单克隆抗体,与标准一线化疗联合使用时,在晚期非鳞状非小细胞肺癌(ns-NSCLC)中显示出显著的临床获益。我们的研究旨在调查在至少一种先前化疗方案失败后,将贝伐单抗添加到培美曲塞中是否能改善晚期ns-NSCLC患者的无进展生存期(PFS)。符合条件的患者为局部晚期、复发或转移性ns-NSCLC患者,在铂类治疗失败后,其体能状态为0至2。患者在第1天静脉注射(IV)500 mg/m²培美曲塞,并同时给予维生素B12、叶酸和地塞米松,在第1天静脉注射7.5 mg/kg贝伐单抗,每21天为一个周期,直至出现不可接受的毒性、疾病进展或患者要求停止治疗。主要终点是PFS。在2011年12月至2013年10月期间,共纳入33例患者,中位年龄为55岁,男性占36.4%。23例患者(69.7%)接受过两种或更多先前的治疗方案,28例患者(84.8%)接受过含培美曲塞的化疗。方案治疗的中位次数为4次。中位PFS为4.37个月(95%CI 2.64 - 6.09个月)。中位总生存期(OS)为15.83个月(95%CI 10.52 - 21.15个月)。总缓解率为6.45%。疾病控制率为54.84%。未检测到新的安全信号。没有患者发生与药物相关的死亡。每21天使用贝伐单抗和培美曲塞联合治疗对先前治疗失败的ns-NSCLC患者有效,可改善PFS。毒性与这两种药物的历史数据相似,且可耐受。我们的结果可能为中国先前治疗的ns-NSCLC临床实践提供一种更多含贝伐单抗和培美曲塞的方案。