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Phase II study of bevacizumab plus irinotecan on the treatment of relapsed resistant small cell lung cancer

Abstract

Purpose

This phase II study investigates the efficacy and safety of DNA topoisomerase I inhibitor irinotecan plus bevacizumab a monoclonal antibody against VEGF (BEVIRI) in patients with relapsed chemo-resistant SCLC.

Methods

Patients who previously completed treatment with cisplatin–etoposide who relapsed within 3 months, had measurable extensive-stage SCLC, ECOG performance status 0–2 and adequate hematologic, renal and hepatic function, were given intravenous irinotecan 175 mg/m2 plus intravenous bevacizumab 7.5 mg/kg on day 1 and 15 in 30 day cycles for a target of at least four cycles. No patients had received prophylactic intracranial irradiation. Treatment response was assessed with computer tomography scans with the completion of two consecutive cycles. Primary endpoint was overall response rate (ORR).

Results

Thirty-two patients were enrolled and 28 of them were eligible for evaluation of response, toxicity and survival. The median age was 63.5 years (range 48–73). The ORR (CR and PR) was 25 % (95 % CI 8.9–41.0) and including patients with stable disease overall disease control rate at 2 months was 89 % (95 % CI 77.41–100). The median duration of response was 6 months, median progression-free survival was 3 months (mean PFS: 3.2, 95 % CI 2.7–3.7), and median overall survival was 6 months (mean OS: 6.3, 95 % CI 5.4–7.1). The PFS rate at 6 months was 3.6 %, and 1-year OS rate was 3.6 %. The median number of cycles received was 4.5 (range 1–6). There were two (7.1 %) hematologic (neutropenia) and one (3.5 %) non-hematologic (proteinuria) serious grades 3–4 adverse reactions without necessitating treatment discontinuation.

Conclusion

BEVIRI combination in relapsed chemo-resistant SCLC patients demonstrates promising efficacy and low toxicity compared to historical controls. Further investigation is warranted.

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Correspondence to Constantinos Alifieris.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Trafalis, D.T., Alifieris, C., Stathopoulos, G.P. et al. Phase II study of bevacizumab plus irinotecan on the treatment of relapsed resistant small cell lung cancer. Cancer Chemother Pharmacol 77, 713–722 (2016). https://doi.org/10.1007/s00280-016-2983-0

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Keywords

  • Small cell lung cancer
  • Resistant
  • Irinotecan
  • Bevacizumab
  • VEGF
  • Topoisomerase