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Comparison of first-generation EGFR-TKIs combined with low-dose bevacizumab versus osimertinib in untreated advanced

Yingqi Xu1, Yidan Zhang1, Hongping Jin1

  • 1Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Annals of Medicine
|April 25, 2025
PubMed
Abstract

Insights

First-generation EGFR-TKIs with bevacizumab showed similar progression-free survival to osimertinib in advanced EGFR-mutated NSCLC. This combination may be an alternative first-line treatment option for select patients.

Area of Science:

  • Oncology
  • Medical Research

Background:

  • Advanced non-small cell lung cancer (NSCLC) with EGFR mutations presents treatment challenges.
  • First-generation EGFR-tyrosine kinase inhibitors (TKIs) and osimertinib are established treatments.
  • The combination of EGFR-TKIs with bevacizumab is being explored as a therapeutic strategy.

Purpose of the Study:

  • To compare the efficacy of first-generation EGFR-TKIs plus low-dose bevacizumab versus osimertinib as first-line treatment for advanced EGFR-mutated NSCLC.
  • To evaluate objective response rate (ORR) and progression-free survival (PFS).
  • To assess preliminary overall survival (OS) data.

Main Methods:

  • Retrospective study of 161 patients with advanced EGFR-mutated NSCLC.
  • Two groups: bevacizumab (7.5 mg/kg) plus first-generation EGFR-TKIs (A+T group, n=78) and osimertinib monotherapy (osimertinib group, n=83).
  • Data collected from Shanghai Chest Hospital between July 2017 and July 2023.

Main Results:

  • ORR was comparable between groups: 65.4% (A+T) vs. 68.7% (osimertinib).
  • Median PFS was similar: 16.59 months (A+T) vs. 16.82 months (osimertinib).
  • Preliminary OS favored the A+T group (51.75 months vs. 35.55 months), though data are immature (p=0.010).

Conclusions:

  • First-generation EGFR-TKIs combined with low-dose bevacizumab demonstrated comparable PFS to osimertinib in first-line treatment for advanced EGFR-mutated NSCLC.
  • The combination therapy may represent a viable alternative treatment option for specific patient populations.
  • Further research and mature OS data are needed to fully establish the long-term benefits of this combination.
Keywords:
BevazicumabEGFR-TKINSCLClow-doseosimertinib

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