9170 Safety and efficacy of first-line bevacizumab (Bv) plus chemotherapy in elderly patients (pts) with advanced or recurrent non-squamous non-small cell lung cancer (NSCLC): SAiL (MO19390)

Garrido, P.; Thatcher, Nick; Crinò, L.; Dansin, Éric; Laskin, Janessa; Pavlakis, Nick; Tsai, C.M.; Reck, Martin; Schneider, C.; Griesinger, Frank

doi:10.1016/s1359-6349(09)71883-x

Cited by 5 publications

(5 citation statements)

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“…Nevertheless, a subanalysis of the safety and efficacy of bevacizumab in 610 elderly (>65 years) patients in SAiL, a large phase IV trial with 2,172 patients, showed no significant difference in AEs and outcomes in this subgroup [25].…”

Section: Discussionmentioning

confidence: 90%

“…The risk of severe toxicity in patients with lung neoplasms may be particularly increased in elderly patients, as stated in an unspecified retrospective analysis of E4599 [24] . Nevertheless, a subanalysis of the safety and efficacy of bevacizumab in 610 elderly (>65 years) patients in SAiL, a large phase IV trial with 2,172 patients, showed no significant difference in AEs and outcomes in this subgroup [25] .…”

Section: Discussionmentioning

confidence: 90%

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Addition of Bevacizumab to Chemotherapy in Advanced Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

2011

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IntroductionRecently, studies have demonstrated that the addition of bevacizumab to chemotherapy could be associated with better outcomes in patients with advanced non-small cell lung cancer (NSCLC). However, the benefit seems to be dependent on the drugs used in the chemotherapy regimens. This systematic review evaluated the strength of data on efficacy of the addition of bevacizumab to chemotherapy in advanced NSCLC.MethodsPubMed, EMBASE, and Cochrane databases were searched. Eligible studies were randomized clinical trials (RCTs) that evaluated chemotherapy with or without bevacizumab in patients with advanced NSCLC. The outcomes included overall survival (OS), progression-free survival (PFS), response rate (RR), toxicities and treatment related mortality. Hazard ratios (HR) and odds ratios (OR) were used for the meta-analysis and were expressed with 95% confidence intervals (CI).ResultsWe included results reported from five RCTs, with a total of 2,252 patients included in the primary analysis, all of them using platinum-based chemotherapy regimens. Compared to chemotherapy alone, the addition of bevacizumab to chemotherapy resulted in a significant longer OS (HR 0.89; 95% CI 0.79 to 0.99; p = 0.04), longer PFS (HR 0.73; 95% CI 0.66 to 0.82; p<0.00001) and higher response rates (OR 2.34; 95% CI 1.89 to 2.89; p<0.00001). We found no heterogeneity between trials, in all comparisons. There was a slight increase in toxicities in bevacizumab group, as well as an increased rate of treatment-related mortality.ConclusionsThe addition of bevacizumab to chemotherapy in patients with advanced NSCLC prolongs OS, PFS and RR. Considering the toxicities added, and the small absolute benefits found, bevacizumab plus platinum-based chemotherapy can be considered an option in selected patients with advanced NSCLC. However, risks and benefits should be discussed with patients before decision making.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 90%

Addition of Bevacizumab to Chemotherapy in Advanced Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

2011

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“…16 patients and that elderly patients do not experience a higher incidence of common bevacizumab-related AEs than younger patients. 20 The definition of elderly in this preplanned analysis as 65 years or older has previously been used in the oncology literature, 9 although the age cutoff of 70 years or older is increasingly used. 21 AVAiL was conducted at a time when both definitions were considered to be acceptable definitions of elderly, and the use of 65 years as the age cutoff in this preplanned analysis was necessary to achieve sufficient numbers of elderly patients to allow meaningful comparison with nonelderly patients.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Bevacizumab-Based Therapy in Elderly Patients with Advanced or Recurrent Nonsquamous Non-small Cell Lung Cancer in the Phase III BO17704 Study (AVAiL)

Leighl

Zatloukal

Mezger

et al. 2010

Journal of Thoracic Oncology

105

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“…The risk of severe toxicity in patients with lung neoplasms may be particularly increased in elderly patients, as stated in an unspecified retrospective analysis of E4599 [24]. Nevertheless, a subanalysis of the safety and efficacy of bevacizumab in 610 elderly (.65 years) patients in SAiL, a large phase IV trial with 2,172 patients, showed no significant difference in AEs and outcomes in this subgroup [25].…”

Section: Discussionmentioning

confidence: 97%

Addition of bevacizumab to chemotherapy in advanced non-small cell lung cancer: A systematic review and meta-analysis.

Lima¹,

Macedo²,

Sasse³

2010

JCO

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Introduction: Recently, studies have demonstrated that the addition of bevacizumab to chemotherapy could be associated with better outcomes in patients with advanced non-small cell lung cancer (NSCLC). However, the benefit seems to be dependent on the drugs used in the chemotherapy regimens. This systematic review evaluated the strength of data on efficacy of the addition of bevacizumab to chemotherapy in advanced NSCLC. Methods: PubMed, EMBASE, and Cochrane databases were searched. Eligible studies were randomized clinical trials (RCTs) that evaluated chemotherapy with or without bevacizumab in patients with advanced NSCLC. The outcomes included overall survival (OS), progression-free survival (PFS), response rate (RR), toxicities and treatment related mortality. Hazard ratios (HR) and odds ratios (OR) were used for the meta-analysis and were expressed with 95% confidence intervals (CI). Results: We included results reported from five RCTs, with a total of 2,252 patients included in the primary analysis, all of them using platinum-based chemotherapy regimens. Compared to chemotherapy alone, the addition of bevacizumab to chemotherapy resulted in a significant longer OS (HR 0.89; 95% CI 0.79 to 0.99; p = 0.04), longer PFS (HR 0.73; 95% CI 0.66 to 0.82; p,0.00001) and higher response rates (OR 2.34; 95% CI 1.89 to 2.89; p,0.00001). We found no heterogeneity between trials, in all comparisons. There was a slight increase in toxicities in bevacizumab group, as well as an increased rate of treatment-related mortality. Conclusions: The addition of bevacizumab to chemotherapy in patients with advanced NSCLC prolongs OS, PFS and RR. Considering the toxicities added, and the small absolute benefits found, bevacizumab plus platinum-based chemotherapy can be considered an option in selected patients with advanced NSCLC. However, risks and benefits should be discussed with patients before decision making.

show abstract

9170 Safety and efficacy of first-line bevacizumab (Bv) plus chemotherapy in elderly patients (pts) with advanced or recurrent non-squamous non-small cell lung cancer (NSCLC): SAiL (MO19390)

Cited by 5 publications

References 0 publications

Addition of Bevacizumab to Chemotherapy in Advanced Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

Addition of Bevacizumab to Chemotherapy in Advanced Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

Efficacy and Safety of Bevacizumab-Based Therapy in Elderly Patients with Advanced or Recurrent Nonsquamous Non-small Cell Lung Cancer in the Phase III BO17704 Study (AVAiL)

Addition of bevacizumab to chemotherapy in advanced non-small cell lung cancer: A systematic review and meta-analysis.

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