According to the results of a study published in the New England Journal of Medicine, treatment of recurrent or advanced, non–squamous, non–small cell lung cancer with Avastin® (bevacizumab) and chemotherapy resulted in better survival than treatment with chemotherapy alone.
Lung cancer remains the leading cause of cancer-related deaths in the United States. Non–small cell lung cancer (NSCLC) is the most common type of lung cancer, comprising approximately 75–85% of all lung cancers. There are several different subtypes of NSCLC, including squamous carcinoma, adenocarcinoma, and large cell carcinoma.
Avastin is a drug that blocks a protein known as vascular endothelial growth factor (VEGF). VEGF stimulates the growth of new blood vessels.
Drugs that interfere with VEGF can slow or stop the growth of cancer cells. In addition, drugs that interfere with VEGF may improve the delivery of chemotherapy and radiation therapy to cancer cells by normalizing blood supply.
In order to determine whether the addition of Avastin to chemotherapy improves survival among patients with recurrent or advanced (Stage IIIB or IV) NSCLC, researchers conducted a clinical trial among 878 patients. Patients with squamous cell NSCLC were excluded from the study because of concern that they may be more susceptible to serious side effects from Avastin. Patients with brain metastases or bleeding from the lungs were also excluded.
Half the patients were treated with chemotherapy (paclitaxel and carboplatin) alone, and half were treated with chemotherapy plus Avastin.
- Overall survival was 12.3 months among patients treated with chemotherapy plus Avastin and 10.3 months among patients treated with chemotherapy alone.
- Survival without cancer progression was 6.2 months among patients treated with chemotherapy plus Avastin and 4.5 months among patients treated chemotherapy alone.
- A reduction in detectable cancer occurred in 35% of patients treated with chemotherapy plus Avastin, and 15% of patients treated with chemotherapy alone.
- Bleeding problems were more common in patients who received Avastin than in patients who did not receive Avastin (4.4% vs 0.7%), and there were 15 treatment-related deaths in the chemotherapy plus Avastin group.
The researchers conclude that among selected patients with recurrent or advanced NSCLC, the addition of Avastin to chemotherapy results in more adverse effects of treatment but better survival than chemotherapy alone.
Reference: Sandler A, Gray R, Perry MC et al. Paclitaxel-carboplatin Alone or with Bevacizumab for Non-small Cell Lung Cancer. New EnglandJournal of Medicine. 2006;355:2542-50.
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