This article is more than 5 years old. Information may no longer be current.
Maintenance therapy with bevacizumab plus pemetrexed improved PFS in advanced NSCLC
Click Here to Manage Email Alerts
Continued maintenance with bevacizumab plus pemetrexed prolonged PFS in patients with nonsquamous non–small cell lung cancer who achieved disease control after first-line platinum-based chemotherapy plus bevacizumab, according to results of the multicenter, phase 3 AVAPERL study.
“For most patients with advanced NSCLC who lack [specific] mutations, optimizing treatment options during induction and maintenance remains a priority,” researchers wrote. “Maintenance therapy is associated with improved survival in patients with NSCLC, but few studies have compared active agents in this setting.”
The randomized, open-label trial included 376 patients with advanced disease who received induction treatment with bevacizumab (Avastin, Genentech) 7.5 mg/kg, cisplatin 75 mg/m2 and pemetrexed (Alimta, Eli Lilly) 500 mg/m2 once every 3 weeks for four cycles.
The 71.9% of patients who achieved complete response, partial response or stable disease were eligible for maintenance therapy. Researchers assigned 125 of those patients to a maintenance regimen with single-agent bevacizumab, and they assigned 128 to bevacizumab plus pemetrexed.
PFS served as the primary endpoint.
At median follow-up of 8.1 months, researchers reported significantly longer PFS among patients assigned to the combination maintenance regimen compared with those who received bevacizumab alone (7.4 months vs. 3.7 months; HR=0.48; 95% CI, 0.35-0.66). Researchers observed the survival benefit across subgroups based on patient age, performance status, smoking history and induction response (stable disease vs. partial response).
Adverse events were more common in patients assigned to bevacizumab plus pemetrexed. Rates of grade ≥3 adverse events were 37.6% in the combination arm and 21.7% in the single-agent bevacizumab arm.
No new safety signals were observed, researchers said.
“Although AVAPERL lacked a pemetrexed-alone arm to allow for direct comparison with this maintenance, comparative data for the two AVAPERL arms support the benefit of maintenance therapy with the combination of bevacizumab and pemetrexed relative to bevacizumab alone in patients with advanced nonsquamous NSCLC,” the researchers concluded.
Click Here to Manage Email Alerts