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Cancers: Real-world study shows that adding bevacizumab to afatinib does not significantly improve outcomes in patients with EGFR-sensitive NSCLC

 Last Update: 2022-01-23
 Source: Internet
 Author: User

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The efficacy of afatinib alone or in combination with bevacizumab in patients with epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer ( NSCLC ) is unclear
.

Therefore, scholars from Taiwan, China, conducted a real-world study to evaluate the efficacy of afatinib alone or in combination with bevacizumab in patients with EGFR-mutant NSCLC

Lung cancerNSCLC

A total of 405 patients with advanced NSCLC with sensitizing EGFR mutations received first-line afatinib alone or in combination with bevacizumab and were group- and propensity-score-matched
.

Progression-free survival (PFS), overall survival (OS) and secondary T790M mutation were analyzed

Of the 405 patients included, 367 (90.
6%) received afatinib monotherapy and 38 (9.
4%) received afatinib plus bevacizumab
.

After PSM matching, 152 patients were included, including 34 in the single-agent group and 118 in the combination group

The median follow-up time was 23.
5 months and 37.
8 months in the afatinib plus bevacizumab and afatinib monotherapy groups, respectively
.

The intracranial response rate and intracranial disease control rate were 38.

Efficacy assessment

Median progression-free survival (16.
1 vs.
15.
0 months; log-rank p = 0.
500), reduced risk of disease progression (HR 0.
85 [95% CI, 0.
52-1.
40]; p = 0.
528)) and 24-month Progression survival (40.
9% [95% CI, 25.
6%-65.
3%] vs.
32.
2% [95% CI, 24.
6%-42.
3%]) was similar between the combination and monotherapy groups
.

Median OS (32.

PFS and OS

Male patients (HR 0.
56 [95% CI, 0.
23-1.
35]; p = 0.
198), patients ≥65 years of age (HR 0.
51 [95% CI, 0.
17-1.
51]; p = 0.
222), and patients with liver metastases (HR 0.
57 [95% CI, 0.
19-1.
72]; p = 0.
318) the addition of bevacizumab did not improve PFS
.

PFS subgroup analysis

Male patients (HR 0.
58 [95% CI, 0.
13 2.
63]; p = 0.
486), patients with EGFR L858R mutation (HR 0.
65 [95% CI, 0.
19 2.
17]; p = 0.
485), and patients without brain metastases (HR 0.
53 [95% CI, 0.
16 1.
75]; p = 0.
296) the addition of bevacizumab did not improve patient OS
.

OS subgroup analysis

Of the 405 patients, 279 (68.
9%) had disease progression at the time of data analysis
.

A total of 170 (42.

diagnosis

Factors associated with positive T790M mutation

In conclusion, real-world data suggest that the addition of bevacizumab to afatinib does not significantly improve the prognosis of patients with EGFR-sensitive mutant NSCLC

Original source:

Kuo, C.

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