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L. Shi

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    P1.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 206)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Advanced Diseases - NSCLC
    • Presentations: 1
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      P1.01-065 - Bevacizumab Combined with Chemotherapy in the Treatment of Advanced NSCLC Patients (ID 386)

      09:30 - 17:00  |  Author(s): L. Shi

      • Abstract
      • Slides

      Bevacizumab is a monoclonal antibody which selectively binds to human vascular endothelia growth factor(VEGF).The combination of bevacizumab with chemotherapy has been one of the choices for advanced non-squamous non-small cell lung cancer(NSNSCLC) patients.In this study we evaluate the efficacy,safety and imaging findings of bevacizumab plus chemotheray in patients with advanced NSNSCLC.In addition, the mutation status of EGFR gene and KRAS gene were detected.

      Patients adimitted in the hospital were treated with bevacizumab (15mg/kg or 7.5mg/kg, d1) plus chemotherapy(paclitaxel 175mg/m2, d1, carboplatin AUC=5 or 6, d1) with 3 weeks in one cycle,up to 6 cycles,followed with maintenance therapy of bevacizumab(15mg/kg or 7.5 mg/kg, d1) till disease progression. Efficacy, safety, tumoral cavitation, therapeutic outcome of malignant pleural effusion and EGFR, KRAS mutation status were analysed.

      Figure 1 Fig. Imaging changes of pleural effusion before and after treatment. A: Baseline CT of the chest showed plenty of pleural effusion on left side;B: Follow-up CT scan after 4 cycles of therapy demonstrated the pleural effusion had disappeared. 26 Patients were collected.They were all treated with bevacizumab plus chemotherapy.17 patients received maintenance therapy.The median cycle number of chemotherapy was 6, and that of bevacizumab was 8.Partial response(PR), stable disease(SD) and progressive disease(PD) rates were 53.8%, 42.3% and 3.8%,respectively. The median progression free survival(PFS) and overall survival(OS) were11.0 and 25.8 months respectively. Out of 26 patients, 15.4% developed cavitation after treatment.2 years and 3 years survivle rates of cavitation group were lightly higher than those of non-cavitation group(75.0% vs 44.4%, P=0.293, 25.0% vs 12.5%, P=0.509, respectively). Of the 13 patients with malignant pleural effusion, disease control rate of malignant pleural effusion was 100%: complete response(CR) rate was 38.5% and SD rate was 61.5%. EGFR gene ststus were detected in 11 patients. 36.4% showed sensitive mutation. The PR rate of EGFR mutation positive group was higher than that of mutation negitive group (75% vs 28.6%, P=0.262),but not statistically. KRAS mutation has not been found in all the 10 patients whose samsples were capable of being detected. Common adverse effects included myelosuppression, digestive symptoms,epistaxis, ect. Special adverse effects were also observed such as hemoptysis,hypertension,proteinuria etc. Most adverse effects were mild and controllable.

      Bevacizumab with chemotherapy is a promising and safe treatment for patients with NSNSCLC. It was also effective in controlling malignant pleural effusion. Tumoral cavitation were found, but the clinical significance was indeterminate. The relationship of EGFR gene status and efficacy of bevacizumab-based chemotheray is subject to further research.

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