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Isolating the Role of Bevacizumab in Elderly Patients With Previously Untreated Nonsquamous Non–Small Cell Lung Cancer: Secondary Analyses of the ECOG 4599 and PointBreak Trials

Patient-level data from 2 phase III studies in patients with previously untreated, advanced-stage, nonsquamous non–small cell lung cancer (NSCLC) were pooled to examine outcomes with bevacizumab and chemotherapy based on age. METHODS: Data from patients randomized to paclitaxel–carboplatin (PC)+beva...

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Autores principales: Langer, Corey J., Socinski, Mark A., Patel, Jyoti D., Sandler, Alan B., Schiller, Joan H., Leon, Larry, Hazard, Sebastien J., Ramalingam, Suresh S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5016219/
https://www.ncbi.nlm.nih.gov/pubmed/25628268
http://dx.doi.org/10.1097/COC.0000000000000163
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author Langer, Corey J.
Socinski, Mark A.
Patel, Jyoti D.
Sandler, Alan B.
Schiller, Joan H.
Leon, Larry
Hazard, Sebastien J.
Ramalingam, Suresh S.
author_facet Langer, Corey J.
Socinski, Mark A.
Patel, Jyoti D.
Sandler, Alan B.
Schiller, Joan H.
Leon, Larry
Hazard, Sebastien J.
Ramalingam, Suresh S.
author_sort Langer, Corey J.
collection PubMed
description Patient-level data from 2 phase III studies in patients with previously untreated, advanced-stage, nonsquamous non–small cell lung cancer (NSCLC) were pooled to examine outcomes with bevacizumab and chemotherapy based on age. METHODS: Data from patients randomized to paclitaxel–carboplatin (PC)+bevacizumab in the Eastern Cooperative Oncology Group 4599 (E4599) and PointBreak studies were pooled and compared with E4599 patients randomized to PC alone. Patients were grouped by age: below 65, 65 to 74, 70 to 74, below 75, and 75 years or above. A multivariable model was used to calculate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) using time-to-event outcomes. Adverse events (AEs) were assessed by age group in each study. RESULTS: The PC+bevacizumab and PC arms comprised 901 and 444 patients, respectively. PC+bevacizumab was associated with significant increases in overall survival relative to PC in patients below 65 years (hazards ratio [HR], 0.75; 95% confidence interval [CI], 0.62-0.89), 65 to 74 years (HR, 0.80; 95% CI, 0.64-1.00), 70 to 74 years (HR, 0.68; 95% CI, 0.48-0.96), and below 75 years (HR, 0.78; 95% CI, 0.68-0.89) but not in those aged 75 years or above (HR, 1.05; 95% CI, 0.70-1.57). Increased incidence of grade ≥3 AEs was reported with PC+bevacizumab versus PC in patients below 75 years (63% vs. 48%; P<0.05) and 75 years or above (81% vs. 56%; P <0.05) in E4599. CONCLUSIONS: This analysis suggests that the survival benefits associated with PC+bevacizumab extend to patient subgroups below 75 years with advanced-stage NSCLC; no benefit, however, was observed for bevacizumab-eligible patients who were 75 years or above.
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spelling pubmed-50162192016-10-01 Isolating the Role of Bevacizumab in Elderly Patients With Previously Untreated Nonsquamous Non–Small Cell Lung Cancer: Secondary Analyses of the ECOG 4599 and PointBreak Trials Langer, Corey J. Socinski, Mark A. Patel, Jyoti D. Sandler, Alan B. Schiller, Joan H. Leon, Larry Hazard, Sebastien J. Ramalingam, Suresh S. Am J Clin Oncol Original Articles: Thoracic Patient-level data from 2 phase III studies in patients with previously untreated, advanced-stage, nonsquamous non–small cell lung cancer (NSCLC) were pooled to examine outcomes with bevacizumab and chemotherapy based on age. METHODS: Data from patients randomized to paclitaxel–carboplatin (PC)+bevacizumab in the Eastern Cooperative Oncology Group 4599 (E4599) and PointBreak studies were pooled and compared with E4599 patients randomized to PC alone. Patients were grouped by age: below 65, 65 to 74, 70 to 74, below 75, and 75 years or above. A multivariable model was used to calculate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) using time-to-event outcomes. Adverse events (AEs) were assessed by age group in each study. RESULTS: The PC+bevacizumab and PC arms comprised 901 and 444 patients, respectively. PC+bevacizumab was associated with significant increases in overall survival relative to PC in patients below 65 years (hazards ratio [HR], 0.75; 95% confidence interval [CI], 0.62-0.89), 65 to 74 years (HR, 0.80; 95% CI, 0.64-1.00), 70 to 74 years (HR, 0.68; 95% CI, 0.48-0.96), and below 75 years (HR, 0.78; 95% CI, 0.68-0.89) but not in those aged 75 years or above (HR, 1.05; 95% CI, 0.70-1.57). Increased incidence of grade ≥3 AEs was reported with PC+bevacizumab versus PC in patients below 75 years (63% vs. 48%; P<0.05) and 75 years or above (81% vs. 56%; P <0.05) in E4599. CONCLUSIONS: This analysis suggests that the survival benefits associated with PC+bevacizumab extend to patient subgroups below 75 years with advanced-stage NSCLC; no benefit, however, was observed for bevacizumab-eligible patients who were 75 years or above. Lippincott Williams & Wilkins 2016-10 2015-01-26 /pmc/articles/PMC5016219/ /pubmed/25628268 http://dx.doi.org/10.1097/COC.0000000000000163 Text en Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0/.
spellingShingle Original Articles: Thoracic
Langer, Corey J.
Socinski, Mark A.
Patel, Jyoti D.
Sandler, Alan B.
Schiller, Joan H.
Leon, Larry
Hazard, Sebastien J.
Ramalingam, Suresh S.
Isolating the Role of Bevacizumab in Elderly Patients With Previously Untreated Nonsquamous Non–Small Cell Lung Cancer: Secondary Analyses of the ECOG 4599 and PointBreak Trials
title Isolating the Role of Bevacizumab in Elderly Patients With Previously Untreated Nonsquamous Non–Small Cell Lung Cancer: Secondary Analyses of the ECOG 4599 and PointBreak Trials
title_full Isolating the Role of Bevacizumab in Elderly Patients With Previously Untreated Nonsquamous Non–Small Cell Lung Cancer: Secondary Analyses of the ECOG 4599 and PointBreak Trials
title_fullStr Isolating the Role of Bevacizumab in Elderly Patients With Previously Untreated Nonsquamous Non–Small Cell Lung Cancer: Secondary Analyses of the ECOG 4599 and PointBreak Trials
title_full_unstemmed Isolating the Role of Bevacizumab in Elderly Patients With Previously Untreated Nonsquamous Non–Small Cell Lung Cancer: Secondary Analyses of the ECOG 4599 and PointBreak Trials
title_short Isolating the Role of Bevacizumab in Elderly Patients With Previously Untreated Nonsquamous Non–Small Cell Lung Cancer: Secondary Analyses of the ECOG 4599 and PointBreak Trials
title_sort isolating the role of bevacizumab in elderly patients with previously untreated nonsquamous non–small cell lung cancer: secondary analyses of the ecog 4599 and pointbreak trials
topic Original Articles: Thoracic
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5016219/
https://www.ncbi.nlm.nih.gov/pubmed/25628268
http://dx.doi.org/10.1097/COC.0000000000000163
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