A multicenter phase II study of docetaxel, oxaliplatin, and bevacizumab in first-line therapy for unresectable locally advanced or metastatic non-squamous cell histology non-small-cell lung cancer (NSCLC)

Abstract

The addition of bevacizumab to docetaxel/oxaliplatin is effective with an acceptable safety profile in patients with chemotherapy-naïve advanced NSCLC.

Phase II study of carboplatin, docetaxel and bevacizumab for chemotherapy-naïve patients with advanced non-squamous non-small cell lung cancer

“…To expand the clinical utility of bevacizumab in front-line treatment of patients with non-squamous NSCLC, a variety of combinations have been reported with promising results. These combinations include regimens with oxaliplatin [31][32][33] as a platinum agent, vinorelbine [34], docetaxel [33,[35][36][37], pemetrexed [32,[38][39][40][41], nanoparticle albumin-bound paclitaxel [42], oral S-1 [43,44], and ixabepilone [40]. The present study provided further evidence of the high efficacy of a 3-drug combination chemotherapy including bevacizumab for the treatment of advanced nonsquamous NSCLC.…”

Trial Watch

“…During the last 13 mo, the clinical profile of oxaliplatin as an off label therapeutic intervention has been assessed in patients with (1) aggressive relapsed or refractory CLL, as part of a chemotherapeutic regimen involving fludarabine, cytarabine (a nucleoside analog approved for the treatment of various hematological malignancies), and rituximab (a CD20-targeting monoclonal antibody currently employed against CLL and NHL); 72 (2) refractory germ cell tumors, in combination with bevacizumab; 73 (3) breast carcinoma, combined with capecitabine (the precursor of 5-fluorouracil) or docetaxel (a microtubular inhibitor of the taxane family currently employed against various carcinomas); 74 , 75 (4) NSCLC, as part of a docetaxel-based chemotherapy; 76 , 77 (5) advanced nasopharyngeal carcinoma, coupled to radiation therapy; 78 (6) gastric or gastresophageal carcinoma, most frequently in the context of a chemotherapeutic cocktail involving docetaxel, capecitabine, or S-1 (an oral fluoropyrimidine currently approved for the treatment of gastric cancer); 79 - 90 (7) pancreatic, gallbladder, or biliary tract tumors, often in combination with gemcitabine-based chemotherapy; 91 - 94 (8) ovarian or bladder carcinoma, combined with conventional (often gemcitabine-based) therapeutic interventions; 95 - 97 or (9) various solid tumors, again in combination with cytotoxic chemotherapy 98 , 99 . Taken together, the results of these clinical trials, most of which were Phase I or II studies, indicate that oxaliplatin exerts promising antineoplastic effects in patients affected by several tumors other than colorectal carcinoma.…”

Safety profile of combined therapy inhibiting EFGR and VEGF pathways in patients with advanced non‐small‐cell lung cancer: A meta‐analysis of 15 phase II/III randomized trials

“…The most wildly used anti‐VEGF agent bevacizumab was the first agent against VEGF to be approved for the treatment of advanced NSCLC . Its efficacy and safety have been investigated in multiple clinical trials, demonstrating that the addition of bevacizumab to chemotherapy was effective with an acceptable safety profile in patients with NSCLC . However, Dudek et al .…”

“…4 Its efficacy and safety have been investi-gated in multiple clinical trials, demonstrating that the addition of bevacizumab to chemotherapy was effective with an acceptable safety profile in patients with NSCLC. [24][25][26][27][28][29][30][31] However, Dudek et al showed that biweekly therapy with combination of carboplatin, gemcitabine, and bevacizumab provided limited benefit and was associated with excessive toxicity in patients with advanced inoperable NSCLC. 32 Despite that lifethreatening AEs may occur, based on existing evidence, side effects associated with bevacizumab are generally mild to moderate in severity and manageable.…”