to paclitaxel/carboplatin, prolongs survival in previously untreated patients with advanced non-small-cell lung cancer: preliminary results from the ECOG Lung Cancer: Secondary Analyses of the ECOG and PointBreak Trials. Eastern Cooperative Oncology Group (E) and PointBreak studies. ECOG demonstrated longer progression-free (PFS) and overall survival ( OS) with the addition of bevacizumab at a dose of 15 mg/m2.

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Two randomized eckg II studies are also included in the meta-analysis and evaluated bevacizumab added to paclitaxel [ 1314 ]. Overall survival with cisplatin—gemcitabine and bevacizumab or placebo as first-line therapy for nonsquamous non-small-cell lung cancer: Outcomes for elderly, advanced-stage non-small-cell lung cancer patients treated with bevacizumab in combination with carboplatin and paclitaxel: Gemcitabine plus bevacizumab compared with gemcitabine plus placebo in patients with advanced pancreatic cancer: It was originally intended that this summary level analysis would be followed by individual patient data but this aspect of the work unfortunately was not carried out.

The optimal dose of bevacizumab also remains unclear, although the ECOG trial using the higher dose was the only trial to show significant improvement in survival. As mentioned above, any 499 interaction with gemcitabine is likely to be small.

Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer.

Attempts to increase the activity of chemotherapy in a non-selective manner have included the addition of monoclonal antibodies, in particular, antibodies directed against the epidermal growth factor receptor EGFR or against the vascular endothelial growth factor VEGF.

Paclitaxel—carboplatin alone or with bevacizumab for non-small-cell lung cancer.

However, a majority of patients do not have this option and continue to be offered standard doublet chemotherapy. Subset analysis suggested that older patients derived no benefit from the addition of bevacizumab [ 10 ]. This strategy has been only marginally successful.


Since then it has been established that gemcitabine is inferior to pemetrexed in non-squamous histology [ 1 ]. Rapid chemotherapy-induced actue endothelial progenitor cell mobilization: The median survival was As discussed earlier, the paper is also diminished by the fact that individual patient data were not utilized and updates beyond those of the initial database were not carried out.

Erratum in N Engl J Med. Patients on the bevacizumab arm also received maintenance bevacizumab; however, the relative value of its administration with chemotherapy or as single-agent maintenance remains unknown since the two individual study components were not separately evaluated. We do not believe so and consider an evidence-based survival benefit to be limited to paclitaxel and carboplatin.

Maintenance pemetrexed significantly increased PFS and in early reporting showed a positive trend for survival. Clinical experience has generally been less favorable in gemcitabine-based trials [ 1920 ]. N Engl J Med. Chemotherapy was administered every 3 weeks for six cycles, and bevacizumab was administered every 3 weeks until disease progression was evident or toxic effects were intolerable.

Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer.

Three of the trials used a paclitaxel Taxol -based regimen and one used gemcitabine. Recently, two additional randomized trials have eco us with new data on bevacizumab. Maintenance chemotherapy for advanced non-small cell lung cancer: Nevertheless, it suggests that the addition of bevacizumab to paclitaxel-based doublet chemotherapy since its approval in the United States has not led to improved survival data in this Medicare population.

First, none of the tests for heterogeneity reached statistical significance and therefore, only the results of fixed effects models are provided. Between July and Aprilthe Eastern Cooperative Oncology Group ECOG conducted a randomized study in which patients with recurrent or advanced non-small-cell lung cancer stage IIIB or IV were assigned to chemotherapy with paclitaxel and carboplatin alone or paclitaxel and carboplatin plus bevacizumab Receive exclusive offers and updates from Oxford Academic.


A later survival analysis failed to show a survival benefit for the triplet regimen [ 12 ]. All the remaining authors have declared no conflicts of interest.

Doublet platinum-based 4599 has been accepted evidence-based therapy for the last two decades. Randomized phase II study of first-line carboplatin-paclitaxel with or without bevacizumab in Fcog patients with advanced non-squamous non-small-cell lung cancer. Randomized phase II trial comparing bevacizumab plus carboplatin and paclitaxel with carboplatin and paclitaxel alone in previously untreated locally advanced or metastatic non-small-cell lung cancer.

Carboplatin and paclitaxel with vs without bevacizumab in older patients with advanced non-small cell lung cancer.

In this edition of Annals of OncologySoria et al. ECOG will continue to dominate current treatment recommendations and the only evidence-based regimen to which bevacizumab should reasonably be added as a standard remains carboplatin and paclitaxel. The role of bevacizumab in the maintenance setting remains unclear. The efog of bevacizumab to pemetrexed remains of some interest. Bevacizumab, a monoclonal antibody against vascular endothelial growth factor, has been shown to benefit patients with a variety of cancers.

Both bevacizumab and pemetrexed can be administered as maintenance and it will be crucial to determine if both the drugs together truly outperform the individual drugs in that setting. They also conclude that bevacizumab showed greater efficacy in patients with adenocarcinoma, and lower body weight loss, but detected no apparent interaction efog the treatment effect with age.

Vandetanib plus pemetrexed for the second-line treatment of advanced non-small-cell lung cancer: Palliative chemotherapy improves the quality of life and prolongs survival in patients with metastatic non-small-cell lung cancer NSCLC.

Sign In or Create an Account. Finally, predictive markers are needed.

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