121P - Safety and efficacy of bevacizumab in "fragile" patients with advanced non-small cell lung cancer

Date 07 May 2017
Event ELCC 2017
Session Poster Display Session
Topics Non-Small-Cell Lung Cancer, Metastatic
Cancer Immunology and Immunotherapy
Lung and other Thoracic Tumours
Presenter Charilaos Maragkos
Citation Annals of Oncology (2017) 28 (suppl_2): ii28-ii51. 10.1093/annonc/mdx091
Authors C. Maragkos1, D. Grapsa2, G. Koumakis3, A. Polyzos2, K. Syrigos2
  • 1University of Athens School of Medicine, 115 27 - Athens/GR
  • 2University of Athens School of Medicine, Athens/GR
  • 3“Agios Savvas” Anticancer Hospital, Athens/GR

Abstract

Background

Bevacizumab is the first antiangiogenic agent approved for treatment of advanced non-squamous NSCLC. Elderly or other “fragile” patients, such as those with poor performance status (PS), comprise the majority of the NSCLC population, but are typically underrepresented in clinical trials. The primary aim of this study was to investigate the efficacy and safety of first-line bevacizumab in “real-world” patients with advanced NSCLC.

Methods

The medical records of all patients with histologically or cytologically confirmed advanced-stage non-squamous NSCLC, treated with first-line bevacizumab (plus chemotherapy) at the Oncology Clinic of “Sotiria” Athens University Hospital between January 2008 and December 2012 were retrospectively reviewed. Selected patients were stratified according to age, i.e. elderly (> 70 years) vs non-elderly (≤70 years), ECOG PS (0-1 vs 2-3) and other demographic, clinicopathological and treatment data. Main outcome measures were overall survival (OS) and treatment-related toxicity.

Results

A total of 145 cases (mean age/SD=61.7 ± 10.6 years) were included. 23,4% of patients were elderly, while 15.8% had poor PS (2-3). Maintenance bevacizumab (with or without pemetrexed) was administered in 24.1% of all cases, including only patients with good PS, and mainly non-elderly. The presence of comorbidities was significantly associated with poor PS and age> 70 years. No statistically significant difference with regard to OS, or type and frequency of side effects was observed between elderly and non-elderly patients. A similar toxicity profile was also observed between patients with good versus poor PS. Absence of maintenance bevacizumab and poor PS were both significantly associated with reduced OS, both in univariate [HR (95% CI): 0.45 (0.22-0.9); p = 0.023 and HR (95% CI): 2.16 (1.29-3.64); p = 0.004, respectively] and in multivariate analysis [[HR (95% CI): 0.47 (0.22-0.99); p = 0.048 and HR (95% CI): 1.76 (1.04-3.00); p = 0.036, respectively].

Conclusions

Our findings suggest that first-line bevacizumab may show similar efficacy and toxicity in elderly versus non-elderly patients with advanced NSCLC. Further prospective data are needed to confirm these observations.

Clinical trial identification

Legal entity responsible for the study

University of Athens

Funding

University of Athens

Disclosure

All authors have declared no conflicts of interest.