Research Activities February 2013, No. 390
Bevacizumab, when added to chemotherapy regimen for elderly patients with lung cancer, does not increase survival rates
Patients with non-small cell lung cancer (NSCLC) are usually diagnosed at an advanced stage when cure is rarely obtainable. Treatment outcomes from chemotherapy remain disappointing, with 1-year survival less than 50 percent. Bevacizumab is a new drug that inhibits tumor growth and metastases. Following a clinical trial demonstrating a significant survival advantage for bevacizumab combined with carboplatin and paclitaxel over carboplatin-paclitaxel alone, the U.S. Food and Drug Administration approved bevacizumab-carboplatin-paclitaxel as treatment for advanced non-squamous cell NSCLC. However, a new study suggests that adding bevacizumab to the other two drugs does not confer a survival advantage for patients 65 years and older.
The researchers analyzed data on 5,670 patients 65 years and older from the SEER-Medicare database, with stage IIIB or stage IV non-squamous cell NSCLC, controlling for demographic and clinical patient attributes. Given the findings of their study and that of other research, the authors conclude that bevacizumab should not be considered standard of care in this context. They recommend that clinicians exercise caution in making treatment recommendations and should use bevacizumab judiciously for their older patients. This study was supported by the Agency for Healthcare Research and Quality (Contract No. 290-10-00006).
See "Carboplatin and paclitaxel with vs without bevacizumab in older patients with advanced non-small cell lung cancer," by Junya Zhu, M.S., Dhruv B. Sharma, Ph.D., Stacy W. Gray, M.D., and others in the April 18, 2012 Journal of the American Medical Association 307(15), pp. 1593-1601.