Bevacizumab in the treatment of advanced non-small-cell lung cancer

This trial examined whether bevacizumab (Avastin) is a safe and effective drug for treating patients with advanced NSCLC. The authors concluded that despite varying treatment lengths and dosage, the use of bevacizumab results in an increased overall survival.

Bevacizumab is an anti-cancer treatment that blocks the formation of the new blood vessels a tumor needs to grow. Studies have previously shown bevacizumab to be an effective treatment for advanced non-small cell lung cancer (NSCLC). It is used in combination with chemotherapy in patients who have undergone a period of chemotherapy treatment (an induction phase [IP]). These studies had limited diversity in their patient population and each patient was administered the same dose of bevacizumab for the same length of time. In a real life clinical setting, the use of bevacizumab is much more varied.

This study investigated the effectiveness and safety of bevacizumab in a more varied patient population. The study used two different methods. Group 1 included data from 1,453 patients who completed induction therapy with chemotherapy and bevacizumab. Group 2 included data on 1,194 patients (including those from group 1) to determine whether additional cycles of bevacizumab affected overall survival (OS; time from beginning trial until death). Approximately half the patients were treated with bevacizumab within 30 days of induction therapy, while the rest were not.  

Patients in group 2 treated with bevacizumab had an average OS of 15.6 months compared to 11.3 months for patients who were not.

In group 1, the risk of a shorter OS decreased by 2.7% with each additional cycle of treatment with bevacizumab.

15% of patients treated with bevacizumab experienced a side effect to treatment, compared to 10% of those not treated. The most common side effect was high blood pressure (6% of patients). 

The authors concluded that in a real life clinical setting, bevacizumab is safe and effective and can result in prolonged OS for patients with advanced NSCLC.