Assessment of chemotherapy strategy using bevacizumab for non-squamous non-small cell lung cancer in a real-world setting: A multi-institutional observational.

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Assessment of chemotherapy strategy using bevacizumab for non-squamous non-small cell lung cancer in a real-world setting: A multi-institutional observational study Masayoshi Higashiguchi, Takashi Kijima, Osamu Morimura, Akio Osa, Hidekazu Suzuki, Takako Inoue, Hiroyuki Kagawa, Kiyonobu Ueno, Tomonori Hirashima, Toru Kumagai, Fumio Imamura, Masahide Mori, Yoshiro Tanio, Ichiro Kawase Cancer Treatment and Research Communications Volume 5, Pages 1-10 (January 2016) DOI: 10.1016/j.ctrc.2015.11.004 Copyright © 2015 Elsevier Ltd Terms and Conditions

Fig. 1 (a) Overall survival of patients who underwent chemotherapy with BEV as first-line treatment (N=162). The median overall survival was 23.5 months. The 1-year and 2-year survival rates were 70.3% and 47.6%, respectively. (b) Progression-free survival of patients who underwent chemotherapy with BEV as first-line treatment (N=162). The median progression-free survival was 6.8 months. (c) Overall survival of patients who underwent first-line chemotherapy using BEV analyzed by driver oncogene status.The median overall survival was 18.0 months in the double-negative group, 27.6 months in the EGFR group, and 33.9 months in the ALK group. Survival time of the ALK group was significantly longer as compared to that of the double-negative group (p=0.024). Double-negative group: patients without EGFR mutations nor ALK rearrangements (N=127); EGFR group: patients with tyrosine kinase inhibitor-sensitive EGFR mutations (N=17); ALK group: patients with ALK rearrangements (N=12). (d) Progression-free survival of patients who underwent first-line chemotherapy using BEV analyzed by driver oncogene status. The median progression-free survival was 6.5 months in the double-negative group, 7.1 months in the EGFR group, and 8.7 months in the ALK group. Progression-free survival did not differ significantly among the groups. Cancer Treatment and Research Communications 2016 5, 1-10DOI: (10.1016/j.ctrc.2015.11.004) Copyright © 2015 Elsevier Ltd Terms and Conditions

Fig. 2 (a) Overall survival of the double-negative group who received carboplatin plus paclitaxel with bevacizumab (CBDCA+PTX+BEV; N=74), carboplatin plus pemetrexed with bevacizumab (CBDCA+PEM+BEV; N=35), or cisplatin plus paclitaxel combined with bevacizumab (CDDP+PEM+BEV; N=10) for first-line chemotherapy. The median overall survival was 18.0 months in the CBDCA+PTX+BEV group, 28.6 months in the CBDCA+PEM+BEV group and not reached in the CDDP+PEM+BEV group. The CBDCA+PEM+BEV group had significantly longer survival time as compared to the CBDCA+PTX+BEV group (p=0.040). (b) Progression-free survival of double-negative group who received CBDCA+PTX+BEV, CBDCA+PEM+BEV, or CDDP+PEM+BEV for first-line chemotherapy. The median progression-free survival was 6.2 months in CBDCA+PTX+BEV group, 8.5 months in the CBDCA+PEM+BEV group and 5.6 months in the CDDP+PEM+BEV group. The CBDCA+PEM+BEV group had significantly longer progression-free survival as compared to the CBDCA+PTX+BEV group (p=0.006). Cancer Treatment and Research Communications 2016 5, 1-10DOI: (10.1016/j.ctrc.2015.11.004) Copyright © 2015 Elsevier Ltd Terms and Conditions

Fig. 3 (a) Progression-free survival of double-negative group who received chemotherapy with bevacizumab beyond first progression (BBP group; N=23) and those who received chemotherapy without bevacizumab beyond first progression (no BBP group; N=49) as second-line chemotherapy. (b) Overall survival of double-negative group who received chemotherapy with bevacizumab beyond first progression as second-line chemotherapy (BBP group; N=23) and those who did not receive chemotherapy with bevacizumab in second- and further-line treatments (no BBP group; N=46). Cancer Treatment and Research Communications 2016 5, 1-10DOI: (10.1016/j.ctrc.2015.11.004) Copyright © 2015 Elsevier Ltd Terms and Conditions

Fig. 4 Overall survival of EGFR group who were treated with chemotherapy with bevacizumab as first-line and EGFR-TKI monotherapy as second-line (first BEV and second TKI group; N=9) and patients who were treated in reverse order (first TKI and second BEV group; N=14). Cancer Treatment and Research Communications 2016 5, 1-10DOI: (10.1016/j.ctrc.2015.11.004) Copyright © 2015 Elsevier Ltd Terms and Conditions

Fig. 5 (a)Overall survival of double-negative group who had brain metastases (N=15) and those who did not (N=112). Patients with brain metastases had significantly shorter survival time as compared to those without brain metastases (p=0.040). (b) Progression-free survival of double-negative group who had brain metastases and those who did not. There was no significant difference between the groups (Fig. 5b; p=0.090). Cancer Treatment and Research Communications 2016 5, 1-10DOI: (10.1016/j.ctrc.2015.11.004) Copyright © 2015 Elsevier Ltd Terms and Conditions