Abstract 3568
Background
NSCLC is frequent in elderly patients (pts), however there is limited information on the treatment of this population. This study describes the first-line treatment with bevacizumab (bev) of NSCLC elderly pts in real life in France.
Methods
AVANTAGE is a non-interventional, prospective, multicenter French study conducted in pts with advanced NSCLC starting first-line chemotherapy (CT) with bev. It includes 2 cohorts, pts aged 65-70 (C1), or ≥ 70 (C2) . Data were collected at inclusion and every 3 months subsequently for 18 months. The primary objective was to describe CT used with bev in first-line in routine clinical practice.
Results
A total of 249 pts were eligible (277 included) in 68 centers: 108 (43%) in C1 & 141 (57%) in C2. They were predominantly men (75%), ECOG PS 0-1 (85%) PS 2 (15%), G8 questionnaire score >14 (35%), stage IV (96%), Charlson comorbidity index unadjusted ≤2 (63%), and brain metastases identified in 18% of pts overall, 20% of pts in C2. Platinum-based doublet CT and pemetrexed (pem) was the most used combination with bev in 186 (75%) pts overall: - 81% of pts in C1 (62% cisplatin-pem and 18% carboplatin-pem) - 70% of pts in C2 (26% cisplatin-pem and 44% carboplatin-pem). The initial dose of bev with CT was 7.5 mg/kg/3 weeks in 70% of pts. Overall, maintenance treatment was administered to 61% pts, including 53% with bev (24% in monotherapy and 29% with pem). Maintenance was 64% in C1and 62% in C2. Median PFS was 7.1 months, and median OS was 12.3 months (14.9 months in C1, 11.3 months in C2). Overall, 92% of pts presented at least 1 AE. Pts with grade ≥ 3 AEs related to bev were 12% in C1 and 24% in C2. In the safety population (260), 148 pts died during the study. 3 pts (all in C2) died due to SAEs related to treatment (intestinal perforation; febrile neutropenia/septic shock/ thrombocytopenia; unknown cause).
Conclusions
AVANTAGE is the 1st prospective cohort conducted in routine clinical practice in France in elderly pts eligible for 1st-line CT with bev. The most frequently used treatment was the combination of platinum-pem doublet (75% of pts). Bev effectiveness as 1st line treatment in NSCLC was consistent with the efficacy observed in clinical trials in the elderly as was the safety profile.
Clinical trial identification
Clincial Trial Gov: NCT01893268.
Legal entity responsible for the study
Roche S.A.S.
Funding
Roche S.A.S.
Editorial Acknowledgement
Dr Samia Rahal from ELTIUM (French medical writting company).
Disclosure
F. Lionel, D. Perol, H. Le Caer, P-J. Souquet: Payment for advisory: Roche. E. Dansin: Payment for advisory: Roche, Lilly, MSD. C. Audigier Valette: Payment for advisory: Roche, Pfizer, Boehringer Ingelheim, Lilly, AstraZeneca, Amgen, Bristol-Myers Squibb, Symex, MSD, Clovis Oncology, Novartis. J.-L. Mouysset, E. Fabre-Guillevin: Payment as study's investigator: Roche. M.L. Uffredi, M. Ionescu-Goga: Employee: Roche. K. Veerabudun, Y. Lelarge: Business partner employee: Roche.
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