Bevacizumab plus erlotinib versus erlotinib alone in Japanese patients with advanced, metastatic, EGFR-mutant non-small-cell lung cancer (NEJ026): overall survival analysis of an open-label, randomised, multicentre, phase 3 trial

Overall Survival Benefits of First-Line Treatments for Asian Patients With Advanced EGFR-Mutated NSCLC Harboring L858R Mutation: A Systematic Review and Network Meta-Analysis

“…Finally, 18 studies were deemed eligible for inclusion with a total of 1852 Asian patients with L858R mutation enrolled to receive 12 different treatments, including EGFR TKIs (osimertinib, dacomitinib, afatinib, erlotinib, gefitinib, and icotinib), pemetrexed-based chemotherapy, pemetrexed-free chemotherapy, and combination treatments (gefitinib plus apatinib, erlotinib plus ramucirumab, erlotinib plus bevacizumab, gefitinib plus pemetrexed-based chemotherapy). 17 , 18 , 19 , 20 , 23 , 24 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 36 , 48 , 55 , 56 , 57 , 58 , 59 The networks are displayed in Figure 2 A-C . Detailed information on all the included studies has been presented in Table 1 .…”

“…There were 13 trials of 1257 Asian patients with L858R mutation in this analysis. 17 , 18 , 19 , 20 , 24 , 26 , 28 , 29 , 31 , 34 , 55 , 56 , 57 There was no significant heterogeneity observed ( I 2 = 0%, p = 0.644 for Q statistic), and fixed-effects model was used. Asian patients with L858R mutation had no significant OS benefits from all EGFR TKIs or combination treatments over chemotherapies ( Fig.…”

Therapeutic advances in non‐small cell lung cancer: Focus on clinical development of targeted therapy and immunotherapy

“…In the NEJ026 study, combination therapy (bevacizumab plus erlotinib) also showed an increase in adverse events. 372 The efficacy of antiangiogenesis in combination with immunotherapy has been confirmed in the IMpower150 study. Atezolizumab plus carboplatin plus paclitaxel plus bevacizumab (ACPB) regimen significantly improved the PFS and OS in advanced NSCLC patients, regardless of PD‐L1 expression and EGFR or ALK genetic alteration status.…”

Current Therapeutic Strategies and Prospects for EGFR Mutation-Positive Lung Cancer Based on the Mechanisms Underlying Drug Resistance

“…Outcomes of combination therapy with erlotinib and anti-angiogenesis agents have also been evaluated in several trials. The NEJ026 trial [22,23] was a phase III trial that compared erlotinib monotherapy with erlotinib plus bevacizumab; PFS, the primary endpoint, was prolonged in the combination therapy group (16.9 months vs. 13.3 months, HR 0.605, 95% C.I. 0.417-0.877), but OS did not improve.…”

“…Scientific studies have shown that aspects of the tumor microenvironment, such as survival signals from fibroblasts around cancer cells and poor vascularization around cancer cells, may cause cancer cells to survive EGFR-TKI monotherapy [60]. In fact, combination therapy with angiogenesis inhibitors and EGFR-TKIs, which is believed to inhibit neovascularization, has been shown to prolong PFS in several clinical trials [22,23]. However, there is no clear evidence that it increases the cure rate; moreover, the RELAY study [24], which compared erlotinib monotherapy with erlotinib plus ramucirumab combination therapy, reported no difference in the detection rate of T790M during disease progression.…”