Comparison of chemotherapy plus bevacizumab vs. chemotherapy alone as third-line treatment or beyond for advanced non-small cell lung cancer: A propensity score-matched analysis

Hu,Binbin; Zhou,Xiaojuan; Liu,Yongmei; Li,Qian; Xiang,Mengmeng; Zou,Bingwen; Peng,Feng; Huang,Meijuan; Gong,Youling; Zhu,Jiang; Wang,Yongsheng; Ren,Li; Xu,Yong; Zhang,Yan; Li,Yanying; Yu,Min; Xue,Jianxin; Deng,Lei; Wang,Jin; Ding,Zhenyu; Lu,You

doi:10.3892/ol.2018.8064

Comparison of chemotherapy plus bevacizumab vs. chemotherapy alone as third-line treatment or beyond for advanced non-small cell lung cancer: A propensity score-matched analysis

Authors:
- Binbin Hu
- Xiaojuan Zhou
- Yongmei Liu
- Qian Li
- Mengmeng Xiang
- Bingwen Zou
- Feng Peng
- Meijuan Huang
- Youling Gong
- Jiang Zhu
- Yongsheng Wang
- Li Ren
- Yong Xu
- Yan Zhang
- Yanying Li
- Min Yu
- Jianxin Xue
- Lei Deng
- Jin Wang
- Zhenyu Ding
- You Lu
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Affiliations: Department of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China, West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, P.R. China
Published online on: February 15, 2018 https://doi.org/10.3892/ol.2018.8064
Pages: 5671-5679
Copyright: © Hu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The addition of bevacizumab to chemotherapy has demonstrated efficacy as a first-line treatment for non‑small cell lung cancer (NSCLC). Whether this combination is effective as a salvage treatment for patients with NSCLC remains unclear. The present retrospective study was designed to compare the efficacy and safety of chemotherapy plus bevacizumab with chemotherapy alone as a third‑line, or continuing, treatment for patients with NSCLC. Between January 2011 and June 2016, a total of 38 patients with stage IV NSCLC who had received chemotherapy plus bevacizumab subsequent to failure of ≥2 prior regimens were matched with 38 patients who had received chemotherapy alone using propensity score matching from a dataset of 165 patients. The variables that were analyzed included age, sex, smoking history, histology, epithelial growth factor receptor mutation status, number of prior regimens and type of chemotherapy regimen. Univariate and multivariate analyses were used to evaluate the prognostic factors for survival outcomes and tumor response, and toxicity analyses were performed. The objective response rate (ORR) and disease control rate (DCR) were improved in patients who underwent chemotherapy‑bevacizumab treatment compared with chemotherapy alone (ORR, 23.7 vs. 5.3%, P<0.001; DCR, 65.8 vs. 31.6%, P<0.001). Progression‑free survival was prolonged in the chemotherapy‑bevacizumab group compared with the chemotherapy‑alone group (median, 3.9 vs. 2.2 months; HR, 0.54; 95% CI, 0.32‑0.89, P=0.014). Incidence of ≥grade 3 adverse events was low and similar across the groups. The combination of chemotherapy and bevacizumab is a potentially effective and safe alternative salvage treatment for patients with NSCLC who have not received bevacizumab treatment previously.

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