Department of Respiratory Medicine, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan.
National Kyushu Cancer Center, Fukuoka, Japan.
Drug Saf. 2018 Feb;41(2):229-237. doi: 10.1007/s40264-017-0596-0.
The phase II JO25567 study compared the efficacy and safety of erlotinib plus bevacizumab vs. erlotinib alone as first-line therapy for advanced epidermal growth factor receptor (EGFR) mutation-positive non-small-cell lung cancer (NSCLC).
Our objective is to provide updated analyses of safety and the assessment of manageability of specific adverse events.
Patients with stage IIIB/IV or recurrent, non-squamous, EGFR mutation-positive NSCLC were randomized to receive erlotinib plus bevacizumab or erlotinib. The primary endpoint was progression-free survival. Adverse event frequency rates, predictability and manageability, reasons for discontinuation, time to onset, and outcomes of specific adverse events were analyzed.
The safety analysis population comprised 152 randomized patients (75 erlotinib plus bevacizumab; 77 erlotinib) who received at least one dose of study drug between February 2011 and March 2012. There was no difference in overall incidence of serious adverse events between arms, but more grade 3 or higher adverse events were reported with erlotinib plus bevacizumab (90.7%) than with erlotinib (53.2%), primarily due to grade 3 hypertension. Hypertension was controllable with antihypertensive medications in most cases. Proteinuria and bleeding were also more frequently reported with erlotinib plus bevacizumab than with erlotinib but were manageable and did not lead to early discontinuations.
The addition of bevacizumab to erlotinib prolonged progression-free survival in EGFR mutation-positive NSCLC. Follow-up safety data were consistent with the known safety profiles of both erlotinib and bevacizumab in NSCLC; this combination appeared to be manageable, and treatment was well tolerated. JapicCTI-111390.
JO25567 期研究比较了厄洛替尼联合贝伐珠单抗与厄洛替尼单药作为表皮生长因子受体(EGFR)突变阳性非小细胞肺癌(NSCLC)一线治疗的疗效和安全性。
本研究旨在提供安全性的更新分析,并评估特定不良事件的可管理性。
IIIb/IV 期或复发、非鳞状、EGFR 突变阳性 NSCLC 患者随机接受厄洛替尼联合贝伐珠单抗或厄洛替尼治疗。主要终点是无进展生存期。分析不良事件频率、可预测性和可管理性、停药原因、不良事件发生时间和结局。
安全性分析人群包括 152 例随机患者(厄洛替尼联合贝伐珠单抗 75 例;厄洛替尼 77 例),他们在 2011 年 2 月至 2012 年 3 月期间至少接受了一剂研究药物。两组严重不良事件的总发生率无差异,但厄洛替尼联合贝伐珠单抗组(90.7%)报告的 3 级或更高不良事件多于厄洛替尼组(53.2%),主要是由于 3 级高血压。在大多数情况下,高血压可通过降压药物控制。厄洛替尼联合贝伐珠单抗组的蛋白尿和出血也比厄洛替尼组更频繁,但可管理,且不会导致早期停药。
贝伐珠单抗联合厄洛替尼延长了 EGFR 突变阳性 NSCLC 的无进展生存期。随访安全性数据与厄洛替尼和贝伐珠单抗在 NSCLC 中的已知安全性特征一致;该联合方案似乎可管理,且治疗耐受良好。JapicCTI-111390。