2791 - Efficacy of weekly paclitaxel-bevacizumab combination in advanced non squamous non-small cell lung cancer (NSCLC) : a retrospective multicentric study.

Background

ULTIMATE, a phase III trial, showed a significant superiority in terms of progression free survival (PFS) and less toxicity of the combination paclitaxel-bevacizumab versus docetaxel as second or third-line treatment. With the growing role of immunotherapy as first-line setting for advanced non-small cell lung cancer (NSCLC), there is a need to redefine strategies to failure. The use of the paclitaxel-bevacizumab combination could be an option.

Methods

This retrospective study identified patients treated with paclitaxel and bevacizumab according to the ULTIMATE study in 3 centers in France. Main objectives were to describe safety and efficacy of this combination in metastatic non-squamous NSCLC as second-line therapy or beyond, with a particular interest for the sub-group of patients treated just after immune checkpoint inhibitors.

Results

From 1st September 2010 to 1st avril 2018, 76 patients started the paclitaxel-bevacizumab combination : 42 (55%) male, 18 (24%) and 36 (47%) treated in second and third-line respectively, and 22 (29%) in fourth-line or more. Objective response rate (ORR) was 37% (28/76) and disease control rate 74 % (56/76). Median PFS and OS were 5,7 [95%CI: 4,1-6,9] months and 11,2 [95%CI: 8-not reached] months respectively. For patients treated in second and third-line, ORR was respectively 39% and 42%, PFS 4 months [95%CI: 2,5-7,7] and 6 months [95%CI: 4-7], OS 9,4 months [95%CI: 2,7-not reached] and was not reached in third-line at 12 months. Grade 3–4 adverse events included asthenia 5% (4/76), neurotoxicity 3% (2/76), bleeding events 4% (3/76), and hematological toxicity 1% (1/76). Interestingly, in the subgroup of patients treated with immunotherapy just before paclitaxel-bevacizumab (33/76), ORR was 42% (14/33), median PFS was 6,2 [95% CI: 4,6-7,7] months, and median overall survival was not reached at 12 months.

Conclusions

This results exhibited an acceptable toxicity profile and an encouraging efficacy as second-line treatment or beyond for non-squamous NSCLC patients. For patient treated just after immunotherapy the results are very promising.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Dr Chantal Decroisette CH Annecy Genevois France.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.