Hayashi Shigen, Miyazaki Kunihiko, Shiozawa Toshihiro, Okauchi Shinichiro, Sakurai Hirofumi, Akiyama Tatsuya, Nomura Akihiro, Satoh Hiroaki, Hizawa Nobuyuki
Division of Respiratory Medicine, Ibaraki Seinan Medical Center Hospital, Sakai, Japan.
Division of Respiratory Medicine, Ryugasaki Saiseikai Hospital, Ryugasaki, Japan.
Cancer Diagn Progn. 2023 May 3;3(3):377-382. doi: 10.21873/cdp.10227. eCollection 2023 May-Jun.
BACKGROUND/AIM: Pemetrexed (PEM) and bevacizumab (BEV) are commonly used in combination as second or subsequent line regimens and maintenance therapy after platinum + PEM + BEV therapy for advanced non-small cell lung cancer (NSCLC). Median progression-free survival (PFS) for PEM + BEV has been reported to be less than six months in both clinical trials and clinical practice, but in clinical practice, we found that some patients demonstrate long-term PFS. Furthermore, there is a paucity of clinical practice data on whether long-term administration of PEM + BEV causes renal dysfunction. This study aimed to clarify these aspects in clinical practice.
A retrospective review of patients with advanced NSCLC treated with PEM + BEV between September 2011 and June 2022 at four hospitals was conducted. Long-term PFS in PEM + BEV therapy was defined as ≥12 months.
During the study period, 109 patients received PEM + BEV treatment. Of them, 42 (38.5%) achieved long-term PFS ≥12 months. No significant differences in patient characteristics were found between patients with PFS ≥12 months and <12 months, except for 'relapse after resection'. Univariate and multivariate analysis showed that the favorable factor for PFS was 'relapse after resection'. With regard to influence on renal function of PEM + BEV therapy, no significant difference was found before and after PEM+BEV therapy between these two groups.
NSCLC patients commonly achieved long-term PFS with PEM + BEV therapy with no observed effects on renal function.
背景/目的：培美曲塞（PEM）和贝伐单抗（BEV）联合常用于晚期非小细胞肺癌（NSCLC）铂类+PEM+BEV治疗后的二线或后续治疗方案及维持治疗。在临床试验和临床实践中，PEM+BEV的中位无进展生存期（PFS）均报道少于6个月，但在临床实践中，我们发现一些患者可获得长期PFS。此外，关于长期使用PEM+BEV是否会导致肾功能不全的临床实践数据较少。本研究旨在阐明临床实践中的这些问题。
对2011年9月至2022年6月期间在四家医院接受PEM+BEV治疗的晚期NSCLC患者进行回顾性研究。PEM+BEV治疗中的长期PFS定义为≥12个月。
在研究期间，109例患者接受了PEM+BEV治疗。其中，42例（38.5%）获得了≥12个月的长期PFS。除“切除术后复发”外，PFS≥12个月和<12个月的患者在患者特征方面未发现显著差异。单因素和多因素分析显示，PFS的有利因素是“切除术后复发”。关于PEM+BEV治疗对肾功能的影响，两组在PEM+BEV治疗前后未发现显著差异。
NSCLC患者接受PEM+BEV治疗通常可获得长期PFS，且未观察到对肾功能的影响。
