Platinum-Vinorelbine Induction Chemotherapy plus Bevacizumab With and Without Pemetrexed Switch Maintenance in...

Little information is available until today regarding the effect of platinum-doublet chemotherapy with bevacizumab followed by pemetrexed as a sole maintenance treatment. Original data concerns different induction regimens plus bevacizumab with bevacizumab maintenance to progression in advanced non-squamous non-small cell lung cancer (NSCLC).

Two consecutive groups of patients with advanced non-squamous NSCLC received carboplatin, vinorelbine and bevacizumab for four cycles. Group A (2010-2012) did not receive any maintenance therapy, whereas group B (2012-2013) received pemetrexed switch maintenance (500 mg/m(2)) every three weeks until disease progression.

The median progression-free survival (PFS) was 4.4 months and 7.3 months (p<0.001) and one-year survival was 42% and 52% for Group A (n=20) and B (n=22) patients, respectively. Disease control rates were 65% and 86% (p=0.104). Deep venous thrombosis and pulmonary embolism occurred in three (15%) and seven (32%) patients in group A and B, respectively.

The inferior PFS (p<0.001) without maintenance suggests that induction treatment including bevacizumab should not be planned without subsequent maintenance treatment. Whether it is better to use pemetrexed or bevacizumab, or a combination of both, as maintenance therapy is not yet established.