Bevacizumab in combination with pemetrexed and platinum for elderly patients with advanced non-squamous non-small-cell lung cancer: a retrospective analysis

Abstract

Bevacizumab, an anti-VEGF monoclonal antibody, has significantly improved the clinical outcomes of patients with advanced non-squamous NSCLC (ns-NSCLC). However, the safety and efficacy of bevacizumab for elderly patients with advanced NSCLC require further investigation. Thus, 59 patients were included in the present retrospective study, 22 patients in the bevacizumab plus pemetrexed and platinum (B+PP) group, and 37 patients in the pemetrexed and platinum (PP) group. For the entire cohort of patients, the median OS was 33.3 months, and the 1-year and 2-year overall survival rates were 88.5% and 67.8%, respectively. The median OS and 1-year and 2-year OS rates were 20.5 months, 70.3% and 0%, respectively, in the B+PP group and 33.4 months, 97.0% and 89.4%, respectively, in the PP group (P <0.001). The incidence of grade≥3 adverse events was higher in the B+PP group than in the PP group (27.3% vs. 10.8%, respectively; P=0.204). Univariate and multivariate analyses suggested that the receipt of≥5 cycles of first-line chemotherapy was an independent favorable prognostic factor for OS, whereas the addition of bevacizumab was an unfavorable prognostic factor. With increased toxicities, the addition of bevacizumab to PP does not improve the overall survival of elderly patients with advanced ns-NSCLC.

Keywords

bevacizumab / elderly patient / advanced non-small-cell lung cancer / overall survival / toxicity

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Acknowledgements

We thank the patients for participating in this study. This work was supported by the National Key R&D Program of China (No. 2018YFC1313201), the Innovation Project of Shandong Academy of Medical Sciences (No. 2019-04), and the Academic Promotion Program of Shandong First Medical University (No. 2019ZL002).

Compliance with ethics guidelines

Yaru Tian, Hairong Tian, Xiaoyang Zhai, Hui Zhu, and Jinming Yu declare that they have no competing interests. All procedures involving patients were conformed to Declaration of Helsinki. All patients provided written informed consent before their participation in this study.

Electronic Supplementary Material

Supplementary material is available in the online version of this article at https://doi.org/ 10.1007/s11684-021-0827-8 and is accessible for authorized users.

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