Original Article

Phase 2 trial of maintenance bevacizumab alone after bevacizumab plus pemetrexed and carboplatin in advanced, nonsquamous nonsmall cell lung cancer

  1. James P. Stevenson MD1,†,*,
  2. Corey J. Langer MD1,
  3. Robert A. Somer MD2,
  4. Tracey L. Evans MD1,
  5. Kumar Rajagopalan MD2,
  6. Kimberly Krieger CCRP2,
  7. Mona Jacobs-Small CCRC1,
  8. Nikolas Dyanick1,
  9. Barry Milcarek PhD2,
  10. Susan Coakley CCRP2,
  11. Suzanne Walker CRNP1,
  12. Beth Eaby-Sandy CRNP1,
  13. Alexandre Hageboutros MD2

Article first published online: 27 APR 2012

DOI: 10.1002/cncr.27576

Issue

Cancer

Cancer

Volume 118, Issue 22, pages 5580–5587, 15 November 2012

Additional Information

How to Cite

Stevenson, J. P., Langer, C. J., Somer, R. A., Evans, T. L., Rajagopalan, K., Krieger, K., Jacobs-Small, M., Dyanick, N., Milcarek, B., Coakley, S., Walker, S., Eaby-Sandy, B. and Hageboutros, A. (2012), Phase 2 trial of maintenance bevacizumab alone after bevacizumab plus pemetrexed and carboplatin in advanced, nonsquamous nonsmall cell lung cancer. Cancer, 118: 5580–5587. doi: 10.1002/cncr.27576

Author Information

  1. 1

    Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania

  2. 2

    Cooper Cancer Institute, Voorhees, New Jersey

  1. †

    Fax: (215) 243-3249

*51 North 39th Street, Medical Arts Building, Suite 103A, Philadelphia, PA 19104

  1. †

    Fax: (215) 243-3249

Publication History

  1. Issue published online: 30 OCT 2012
  2. Article first published online: 27 APR 2012
  3. Manuscript Accepted: 6 MAR 2012
  4. Manuscript Revised: 1 MAR 2012
  5. Manuscript Received: 8 FEB 2012

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Keywords:

  • nonsmall cell lung cancer;
  • antiangiogenic therapy;
  • maintenance therapy;
  • phase 2trial;
  • pemetrexed;
  • bevacizumab

Abstract

BACKGROUND:

The authors performed a phase 2 study of bevacizumab plus pemetrexed and carboplatin followed by maintenance bevacizumab in patients with advanced, nonsquamous nonsmall cell lung cancer.

METHODS:

Previously untreated patients with advanced, nonsquamous nonsmall cell lung cancer and an Eastern Cooperative Oncology Group performance status of 0 or 1 received bevacizumab 15 mg/kg, pemetrexed 500 mg/m2 and carboplatin at an area under the concentration-time curve of 6 intravenously on day 1 every 21 days. Responding or stable patients who completed 6 cycles then received bevacizumab maintenance every 21 days until disease progression.

RESULTS:

In total, 43 patients (40 who were evaluable for response) were entered on the study. Treatment-related grade 3/4 toxicities were low and included febrile neutropenia (2%), neutropenia (28%), anemia (18%), thrombocytopenia (11%), hypertension (7%), epistaxis (5%), venous thrombosis (8%), dyspnea (7%), rectovaginal fistula (2.3%), infusion reaction (2%), and cerebrovascular event (2%). One patient died from complications of venous thromboembolism and cerebrovascular accident after Cycle 2. Minimal clinically significant toxicity occurred during maintenance bevacizumab. Two complete responses (5%) were observed, and 17 patients (42%) had a partial response. Fifteen patients (38%) displayed disease stability. The overall disease control rate was 85%. At a median follow-up of 15.8 months, the median progression-free survival was 7.1 months (95% confidence interval, 5.9-8.3 months), and the median overall survival was 17.1 months (95% confidence interval, 8.8-25.5 months).

CONCLUSIONS:

Combined bevacizumab, pemetrexed, and carboplatin followed by maintenance bevacizumab was well tolerated and displayed remarkable activity in patients with previously untreated, advanced, nonsquamous nonsmall cell lung cancer. Cancer 2012. © 2012 American Cancer Society.

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