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Paclitaxel–bevacizumab combination in advanced non-squamous non-small-cell lung cancer (NSCLC): AVATAX, a retrospective multicentric study
INTRODUCTION: Compared with docetaxel, the phase-III trial, ULTIMATE, showed a significant improvement of progression-free survival (PFS) with paclitaxel–bevacizumab combination (PB) as second- or third-line treatment in advanced non-small cell lung cancer (NSCLC). With the increase of immunotherapy...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9174558/ https://www.ncbi.nlm.nih.gov/pubmed/35694190 http://dx.doi.org/10.1177/17588359221099399 |
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author | Bilger, Geoffroy Toffart, Anne-Claire Darrason, Marie Duruisseaux, Michaël Ulmer, Lucie Wang, Pascal Leprieur, Etienne Giroux Girard, Nicolas Massiani, Marie Ange Bore, Paul Descourt, Renaud Pinsolle, Julian Valery, Solene Monnet, Isabelle Swalduz, Aurélie Tissot, Claire Fournel, Pierre Baranzelli, Anne Cortot, Alexis B. Decroisette, Chantal |
author_facet | Bilger, Geoffroy Toffart, Anne-Claire Darrason, Marie Duruisseaux, Michaël Ulmer, Lucie Wang, Pascal Leprieur, Etienne Giroux Girard, Nicolas Massiani, Marie Ange Bore, Paul Descourt, Renaud Pinsolle, Julian Valery, Solene Monnet, Isabelle Swalduz, Aurélie Tissot, Claire Fournel, Pierre Baranzelli, Anne Cortot, Alexis B. Decroisette, Chantal |
author_sort | Bilger, Geoffroy |
collection | PubMed |
description | INTRODUCTION: Compared with docetaxel, the phase-III trial, ULTIMATE, showed a significant improvement of progression-free survival (PFS) with paclitaxel–bevacizumab combination (PB) as second- or third-line treatment in advanced non-small cell lung cancer (NSCLC). With the increase of immunotherapy treatment in first-line settings, the optimal treatment after first-line failure must be redefined. METHODS: This multicentric retrospective study identified all advanced NSCLC patients treated with PB as second-line therapy and beyond. The main efficacy outcomes assessed were objective response rate (ORR), disease control rate (DCR), PFS, and overall survival (OS). The adverse events were reported according to Common Terminology Criteria for Adverse Events (CTCAE). RESULTS: From January 2010 to February 2020, 314 patients in 16 centers received the PB combination. Most patients were male (55%), with a median age of 60 years (19–82), 95% had adenocarcinoma, 27% had a performance status ⩾2, 45% had brain metastases at the time of inclusion. They mostly received the PB combination either in second (20%) or in third-line (39%), and 28% were treated just after ICI failure. ORR and DCR were 40% and 77%, respectively; median PFS and OS were 5.7 [interquartile range (IQR): 3.2–9.6] and 10.8 [IQR: 5.3–19.6] months, respectively. All grade adverse events concerned 82% of patients, including 53% asthenia and 39% neurotoxicity, and 25% of patients continued monotherapy (mostly with bevacizumab) alone due to toxicity. Median PFS for patients treated after ICI failure (ICI+) was significantly superior compared with those not previously treated with ICI (ICI−): 7.0 [IQR: 4.2–11.0] versus 5.2 [IQR: 2.9–8.8] months, p = 0.01, without statistically significant difference for OS between these two groups. In multivariate analysis, factors associated with superior PFS were previous ICI treatment and performance status of 0–1. Only a performance status of 0–1 was associated with superior OS. CONCLUSION: PB combination as second-line treatment or beyond for advanced non-squamous NSCLC had acceptable toxicity and a clinically relevant efficacy and is an option as salvage treatment for these patients, more particularly after ICI progression. |
format | Online Article Text |
id | pubmed-9174558 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-91745582022-06-09 Paclitaxel–bevacizumab combination in advanced non-squamous non-small-cell lung cancer (NSCLC): AVATAX, a retrospective multicentric study Bilger, Geoffroy Toffart, Anne-Claire Darrason, Marie Duruisseaux, Michaël Ulmer, Lucie Wang, Pascal Leprieur, Etienne Giroux Girard, Nicolas Massiani, Marie Ange Bore, Paul Descourt, Renaud Pinsolle, Julian Valery, Solene Monnet, Isabelle Swalduz, Aurélie Tissot, Claire Fournel, Pierre Baranzelli, Anne Cortot, Alexis B. Decroisette, Chantal Ther Adv Med Oncol Original Research INTRODUCTION: Compared with docetaxel, the phase-III trial, ULTIMATE, showed a significant improvement of progression-free survival (PFS) with paclitaxel–bevacizumab combination (PB) as second- or third-line treatment in advanced non-small cell lung cancer (NSCLC). With the increase of immunotherapy treatment in first-line settings, the optimal treatment after first-line failure must be redefined. METHODS: This multicentric retrospective study identified all advanced NSCLC patients treated with PB as second-line therapy and beyond. The main efficacy outcomes assessed were objective response rate (ORR), disease control rate (DCR), PFS, and overall survival (OS). The adverse events were reported according to Common Terminology Criteria for Adverse Events (CTCAE). RESULTS: From January 2010 to February 2020, 314 patients in 16 centers received the PB combination. Most patients were male (55%), with a median age of 60 years (19–82), 95% had adenocarcinoma, 27% had a performance status ⩾2, 45% had brain metastases at the time of inclusion. They mostly received the PB combination either in second (20%) or in third-line (39%), and 28% were treated just after ICI failure. ORR and DCR were 40% and 77%, respectively; median PFS and OS were 5.7 [interquartile range (IQR): 3.2–9.6] and 10.8 [IQR: 5.3–19.6] months, respectively. All grade adverse events concerned 82% of patients, including 53% asthenia and 39% neurotoxicity, and 25% of patients continued monotherapy (mostly with bevacizumab) alone due to toxicity. Median PFS for patients treated after ICI failure (ICI+) was significantly superior compared with those not previously treated with ICI (ICI−): 7.0 [IQR: 4.2–11.0] versus 5.2 [IQR: 2.9–8.8] months, p = 0.01, without statistically significant difference for OS between these two groups. In multivariate analysis, factors associated with superior PFS were previous ICI treatment and performance status of 0–1. Only a performance status of 0–1 was associated with superior OS. CONCLUSION: PB combination as second-line treatment or beyond for advanced non-squamous NSCLC had acceptable toxicity and a clinically relevant efficacy and is an option as salvage treatment for these patients, more particularly after ICI progression. SAGE Publications 2022-06-06 /pmc/articles/PMC9174558/ /pubmed/35694190 http://dx.doi.org/10.1177/17588359221099399 Text en © The Author(s), 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Research Bilger, Geoffroy Toffart, Anne-Claire Darrason, Marie Duruisseaux, Michaël Ulmer, Lucie Wang, Pascal Leprieur, Etienne Giroux Girard, Nicolas Massiani, Marie Ange Bore, Paul Descourt, Renaud Pinsolle, Julian Valery, Solene Monnet, Isabelle Swalduz, Aurélie Tissot, Claire Fournel, Pierre Baranzelli, Anne Cortot, Alexis B. Decroisette, Chantal Paclitaxel–bevacizumab combination in advanced non-squamous non-small-cell lung cancer (NSCLC): AVATAX, a retrospective multicentric study |
title | Paclitaxel–bevacizumab combination in advanced non-squamous
non-small-cell lung cancer (NSCLC): AVATAX, a retrospective multicentric
study |
title_full | Paclitaxel–bevacizumab combination in advanced non-squamous
non-small-cell lung cancer (NSCLC): AVATAX, a retrospective multicentric
study |
title_fullStr | Paclitaxel–bevacizumab combination in advanced non-squamous
non-small-cell lung cancer (NSCLC): AVATAX, a retrospective multicentric
study |
title_full_unstemmed | Paclitaxel–bevacizumab combination in advanced non-squamous
non-small-cell lung cancer (NSCLC): AVATAX, a retrospective multicentric
study |
title_short | Paclitaxel–bevacizumab combination in advanced non-squamous
non-small-cell lung cancer (NSCLC): AVATAX, a retrospective multicentric
study |
title_sort | paclitaxel–bevacizumab combination in advanced non-squamous
non-small-cell lung cancer (nsclc): avatax, a retrospective multicentric
study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9174558/ https://www.ncbi.nlm.nih.gov/pubmed/35694190 http://dx.doi.org/10.1177/17588359221099399 |
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