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Bevacizumab Plus Platinum-Based Chemotherapy

In Advanced Non-Small Cell Lung Cancer

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Abstract

▴ Bevacizumab is a recombinant, humanized vascular endothelial growth factor (VEGF) monoclonal antibody that inhibits tumor growth and tumor metastases. VEGF stimulates angiogenesis in tumors, is involved in early metastatic processes, and is overexpressed in non-small cell lung cancer (NSCLC).

▴ The addition of bevacizumab to standard chemotherapy significantly delayed disease progression in two large, randomized, phase III trials in chemotherapy-naive patients with advanced, nonsquamous NSCLC. In the open-label E4599 trial, median overall survival duration was significantly extended by 2 months and median progression-free survival was significantly increased by 1.7 months when intravenous bevacizumab 15mg/kg once every 3 weeks was added to first-line carboplatin/paclitaxel therapy compared with carboplatin/paclitaxel alone.

▴ In the double-blind AVAiL trial, median progression-free survival was significantly increased (by 0.6 and 0.4 months) by the addition of intravenous bevacizumab 7.5 or 15mg/kg once every 3 weeks to first-line cisplatin/gemcitabine therapy compared with placebo plus cisplatin/gemcitabine. However, median overall survival duration was not significantly improved (13.6 and 13.4 months vs 13.1 months).

▴ Response rates in the E4599 and AVAiL trials were 30–35% in patients receiving bevacizumab plus platinum-based chemotherapy compared with 15% and 20% without bevacizumab.

▴ The safety and tolerability profile of bevacizumab-containing treatment regimens in patients with advanced NSCLC was generally manageable in the E4599 and AVAiL trials, and in two large, ongoing, trials (the open-label SAiL and the observational ARIES studies).

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Acknowledgments and Disclosures

The manuscript was reviewed by: V. Hirsh, McGill University Health Centre, Montreal, Quebec, Canada; C. Manegold, University Medical Center, Department of Surgery, Mannheim, Germany.

The preparation of this review was not supported by any external funding. During the peer review process, the manufacturer of the agent under review was also offered an opportunity to comment on this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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  1. Wolters Kluwer Health ¦ Adis, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, North Shore, 0754, Auckland, New Zealand

    Antona J. Wagstaff, Susan J. Keam & Paul L. McCormack

  2. Wolters Kluwer Health, Philadelphia, Pennsylvania, USA

    Antona J. Wagstaff, Susan J. Keam & Paul L. McCormack

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  1. Antona J. Wagstaff
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  2. Susan J. Keam
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Correspondence to Susan J. Keam.

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Wagstaff, A.J., Keam, S.J. & McCormack, P.L. Bevacizumab Plus Platinum-Based Chemotherapy. BioDrugs 23, 187–196 (2009). https://doi.org/10.2165/00063030-200923030-00005

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