Pemetrexed, Bevacizumab, or the Combination As Maintenance Therapy for Advanced Nonsquamous Non-Small-Cell Lung Cancer: ECOG-ACRIN 5508

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Suresh S RamalingamJoan H Schiller

Abstract

Pemetrexed or bevacizumab is used for maintenance therapy of advanced nonsquamous non-small-cell lung cancer (NSCLC). The combination of bevacizumab and pemetrexed has also demonstrated efficacy. We conducted a randomized study to determine the optimal maintenance therapy. Patients with advanced nonsquamous NSCLC and no prior systemic therapy received carboplatin (area under the curve, 6), paclitaxel (200 mg/m2), and bevacizumab (15 mg/kg) for up to four cycles. Patients without progression after four cycles were randomly assigned to maintenance therapy with bevacizumab (15 mg/kg), pemetrexed (500 mg/m2), or a combination of the two agents. The primary end point was overall survival, with bevacizumab serving as the control group. Of the 1,516 patients enrolled, 874 (57%) were randomly assigned after induction therapy to one of the three maintenance therapy groups. With a median follow-up of 50.6 months, median survival with pemetrexed was 15.9 months, compared with 14.4 months with bevacizumab (hazard ratio [HR], 0.86; P = .12); median survival with pemetrexed and bevacizumab was 16.4 months (HR, 0.9; P = .28); median progression-free survival was 4.2, 5.1 (HR, 0.85; P = .06), and 7.5 months (HR, 0.67; P < .001) for the three g...Continue Reading

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Citations

Dec 28, 2019·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Takashi SetoYoichi Nakanishi
Jan 3, 2020·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Nasser Hanna, Shadia Jalal
Jan 3, 2020·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Li XieBiyun Qian
Jan 3, 2020·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Suresh S Ramalingam, Suzanne E Dahlberg
Feb 18, 2020·Journal of Cancer Research and Clinical Oncology·Huiping QiangTianqing Chu
Nov 13, 2020·The Oncologist·Erin L SchenkPaul A Bunn
Jan 31, 2021·The Lancet. Respiratory Medicine·Anna K Nowak
Mar 9, 2021·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Taofeek K OwonikokoHye Ryun Kim
Jul 7, 2021·Pharmacoepidemiology and Drug Safety·Blythe J S AdamsonAriel B Bourla
Oct 31, 2021·Cytopathology : Official Journal of the British Society for Clinical Cytology·Anthony Maddox, Louise M Smart

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