Switch maintenance therapy with docetaxel and bevacizumab after induction therapy with cisplatin, pemetrexed, and bevacizumab in advanced non-squamous non-small cell lung cancer: a phase II study

• Published in: Medical oncology (Northwood, London, England) London, England), 2018-07, Vol.35 (7), p.108-7, Article 108
• Main Authors: Nishimoto, Koji, Karayama, Masato, Inui, Naoki, Yasui, Hideki, Hozumi, Hironao, Suzuki, Yuzo, Furuhashi, Kazuki, Fujisawa, Tomoyuki, Enomoto, Noriyuki, Nakamura, Yutaro, Inami, Nao, Matsuura, Shun, Kaida, Yusuke, Matsui, Takashi, Asada, Kazuhiro, Matsuda, Hiroyuki, Fujii, Masato, Toyoshima, Mikio, Imokawa, Shiro, Suda, Takafumi
• Format: Article
• Language: English
• Subjects: Aged; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - adverse effects; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Bevacizumab - administration & dosage; Bevacizumab - adverse effects; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - pathology; Chemotherapy; Cisplatin - administration & dosage; Cisplatin - adverse effects; Female; Hematology; Humans; Immunotherapy; Induction Chemotherapy; Internal Medicine; Kaplan-Meier Estimate; Lung cancer; Lung Neoplasms - drug therapy; Lung Neoplasms - pathology; Maintenance Chemotherapy; Male; Medicine; Medicine & Public Health; Middle Aged; Monoclonal antibodies; Neoplasm Staging; Neutropenia; Oncology; Original Paper; Pathology; Pemetrexed - administration & dosage; Pemetrexed - adverse effects; Targeted cancer therapy; Taxoids - administration & dosage; Taxoids - adverse effects; Treatment Outcome
• ISSN: 1357-0560; 1559-131X
• DOI: 10.1007/s12032-018-1172-x

Switch maintenance therapy, using alternative agents that were not administered during induction chemotherapy, is a treatment option for advanced non-squamous non-small cell lung cancer (NSCLC). Bevacizumab is known to increase the efficacy of other chemotherapeutic agents; however, switch maintenance therapy with docetaxel and bevacizumab has not been adequately studied. The goal of this study was to evaluate the efficacy and safety of switch maintenance therapy with docetaxel and bevacizumab following induction therapy with cisplatin, pemetrexed, and bevacizumab. Chemotherapy-naïve non-squamous NSCLC patients received induction therapy of four cycles of cisplatin (75 mg/m 2 ), pemetrexed (500 mg/m 2 ), and bevacizumab (15 mg/kg). Patients who achieved disease control after induction therapy then received maintenance therapy with docetaxel (50 mg/m 2 ) and bevacizumab (15 mg/kg) until disease progression or unacceptable toxicity. The primary endpoint was progression-free survival from enrollment. This study enrolled 49 NSCLC patients, among which 38 (77.6%) completed the four cycles of induction therapy and received maintenance therapy. The median progression-free survival from enrollment was 7.8 months (95% confidence interval: 4.7–11.0 months). The most common toxicities of grade 3 or higher were neutropenia (68.4%), leukopenia (50.0%), febrile neutropenia (31.8%), and hypertension. Switch maintenance therapy with docetaxel and bevacizumab following induction therapy with cisplatin, pemetrexed, and bevacizumab demonstrated modest efficacy and frequent hematologic toxicity in non-squamous NSCLC patients.