Isolating the Role of Bevacizumab in Elderly Patients with Previously Untreated Nonsquamous Non-Small Cell Lung Cancer

Corey J. Langer*, Mark A. Socinski, Jyoti D. Patel, Alan B. Sandler, Joan H. Schiller, Larry Leon, Sebastien J. Hazard, Suresh S. Ramalingam

*Corresponding author for this work

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Background: 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.

Original languageEnglish (US)
Pages (from-to)441-447
Number of pages7
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume39
Issue number5
DOIs
StatePublished - Oct 1 2016

Keywords

  • bevacizumab
  • chemotherapy
  • elderly
  • non-small cell lung cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Langer, C. J., Socinski, M. A., Patel, J. D., Sandler, A. B., Schiller, J. H., Leon, L., Hazard, S. J., & Ramalingam, S. S. (2016). Isolating the Role of Bevacizumab in Elderly Patients with Previously Untreated Nonsquamous Non-Small Cell Lung Cancer. American Journal of Clinical Oncology: Cancer Clinical Trials, 39(5), 441-447. https://doi.org/10.1097/COC.0000000000000163