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Bevacizumab Combined with Continuation of EGFR-TKIs in NSCLC Beyond Gradual Progression

OBJECTIVE: Continuation of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) has shown potential in prolonging survival in patients with non-small cell lung cancer (NSCLC) harboring EGFR mutation who had gradual progression at initial targeting therapy. However, it remains un...

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Autores principales: Xu, Ziyi, Teng, Fei, Hao, Xuezhi, Li, Junling, Xing, Puyuan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9176636/
https://www.ncbi.nlm.nih.gov/pubmed/35693116
http://dx.doi.org/10.2147/CMAR.S363446
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author Xu, Ziyi
Teng, Fei
Hao, Xuezhi
Li, Junling
Xing, Puyuan
author_facet Xu, Ziyi
Teng, Fei
Hao, Xuezhi
Li, Junling
Xing, Puyuan
author_sort Xu, Ziyi
collection PubMed
description OBJECTIVE: Continuation of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) has shown potential in prolonging survival in patients with non-small cell lung cancer (NSCLC) harboring EGFR mutation who had gradual progression at initial targeting therapy. However, it remains unknown whether the combination of bevacizumab and continuation of EGFR-TKIs would benefit this subpopulation. This study retrospectively explored the effect of bevacizumab combined with EGFR-TKIs in NSCLC beyond gradual progression in the real-world setting. METHODS: The records of 48 patients were reviewed who received bevacizumab and continuation of EGFR-TKIs beyond gradual progression at initial targeting therapy. The response to the treatment and post progression survival (PPS) were reviewed and analyzed. RESULTS: The median PPS was 11.4 months (95% CI 7.368–15.492) for all patients included at the median follow-up time of 17.3 months. The objective response rate (ORR) was 8.3%, and the disease control rate (DCR) was 86.1% (with 3 partial response and 28 stable disease) in 36 patients who were evaluable for response with at least one measurable lesion. Univariate Cox analysis showed that age <60, male sex, and EGFR exon19 deletion mutation were associated with longer PPS (P<0.05). Patients harboring EGFR exon19 deletion mutation had significantly longer PPS than those with EGFR exon21 L858R mutation, with an mPPS of 15.5 months and 5.7 months, respectively (HR=0.251, 95% CI 0.112–0.561, P=0.019). Multivariate Cox analysis indicated that age <60 and EGFR exon19 deletion mutation were associated with longer PPS (P<0.05). CONCLUSION: Continuation of EGFR-TKI with the combination of bevacizumab is a reasonable strategy in NSCLC patients beyond gradual progression in previous EGFR-TKI treatment. Younger patients with EGFR exon19 deletion mutation may benefit more from the combination therapy.
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spelling pubmed-91766362022-06-09 Bevacizumab Combined with Continuation of EGFR-TKIs in NSCLC Beyond Gradual Progression Xu, Ziyi Teng, Fei Hao, Xuezhi Li, Junling Xing, Puyuan Cancer Manag Res Original Research OBJECTIVE: Continuation of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) has shown potential in prolonging survival in patients with non-small cell lung cancer (NSCLC) harboring EGFR mutation who had gradual progression at initial targeting therapy. However, it remains unknown whether the combination of bevacizumab and continuation of EGFR-TKIs would benefit this subpopulation. This study retrospectively explored the effect of bevacizumab combined with EGFR-TKIs in NSCLC beyond gradual progression in the real-world setting. METHODS: The records of 48 patients were reviewed who received bevacizumab and continuation of EGFR-TKIs beyond gradual progression at initial targeting therapy. The response to the treatment and post progression survival (PPS) were reviewed and analyzed. RESULTS: The median PPS was 11.4 months (95% CI 7.368–15.492) for all patients included at the median follow-up time of 17.3 months. The objective response rate (ORR) was 8.3%, and the disease control rate (DCR) was 86.1% (with 3 partial response and 28 stable disease) in 36 patients who were evaluable for response with at least one measurable lesion. Univariate Cox analysis showed that age <60, male sex, and EGFR exon19 deletion mutation were associated with longer PPS (P<0.05). Patients harboring EGFR exon19 deletion mutation had significantly longer PPS than those with EGFR exon21 L858R mutation, with an mPPS of 15.5 months and 5.7 months, respectively (HR=0.251, 95% CI 0.112–0.561, P=0.019). Multivariate Cox analysis indicated that age <60 and EGFR exon19 deletion mutation were associated with longer PPS (P<0.05). CONCLUSION: Continuation of EGFR-TKI with the combination of bevacizumab is a reasonable strategy in NSCLC patients beyond gradual progression in previous EGFR-TKI treatment. Younger patients with EGFR exon19 deletion mutation may benefit more from the combination therapy. Dove 2022-06-04 /pmc/articles/PMC9176636/ /pubmed/35693116 http://dx.doi.org/10.2147/CMAR.S363446 Text en © 2022 Xu et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Xu, Ziyi
Teng, Fei
Hao, Xuezhi
Li, Junling
Xing, Puyuan
Bevacizumab Combined with Continuation of EGFR-TKIs in NSCLC Beyond Gradual Progression
title Bevacizumab Combined with Continuation of EGFR-TKIs in NSCLC Beyond Gradual Progression
title_full Bevacizumab Combined with Continuation of EGFR-TKIs in NSCLC Beyond Gradual Progression
title_fullStr Bevacizumab Combined with Continuation of EGFR-TKIs in NSCLC Beyond Gradual Progression
title_full_unstemmed Bevacizumab Combined with Continuation of EGFR-TKIs in NSCLC Beyond Gradual Progression
title_short Bevacizumab Combined with Continuation of EGFR-TKIs in NSCLC Beyond Gradual Progression
title_sort bevacizumab combined with continuation of egfr-tkis in nsclc beyond gradual progression
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9176636/
https://www.ncbi.nlm.nih.gov/pubmed/35693116
http://dx.doi.org/10.2147/CMAR.S363446
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