Bevacizumab in small cell lung cancer

Tiseo et al. published the clinical study evaluating the efficacy and the safety of bevacizumab a humanized monoclonal antibody directed against vascular endothelial growth factor (VEGF), combined with cisplatin and etoposide in first line chemotherapy for patients with extensive-disease (ED) of small-cell lung cancer (SCLC) (1). This is a multicenter, open-label, randomized controlled phase III trial supported by the Gruppo Oncologico Italiano di Ricerca Clinica (GOIRC)—Agenzia Italiana del Farmaco FARM6PMFJM. A total of 205 patients were randomly assigned receiving cisplatin and etoposide with or without bevacizumab. The primary end point was the overall survival (OS). At a median follow-up of 34.9 months, the median OS was improved in the bevacizumab arm (9.8 vs. 8.9 months; hazard ratio (HR) 0.78) with a 1-year survival rates of 37% and 25% respectively (HR 0.78; 95% CI: 0.58–1.06; P=0.113). In addition, the proportion of patients who reported an objective response was 58.4% for the “bevacizumab arm” and 55.3% for the control arm. Among the 96 patients treated with chemotherapy and bevacizumab, 41 patients (42%) continued bevacizumab beyond the preplanned sixth cycles of treatment with a median of four cycles of bevacizumab maintenance; the 65.8% of patients interrupted bevacizumab cause of disease progression. A statistically significant effect on the OS in whose patients receiving the bevacizumab-based maintenance was observed (HR 0.60; P=0.011) along with a well tolerance and as expected; only hypertension was the most frequent adverse event registered in the bevacizumab arm (grade 3 or 4, 6.3% vs. 1.0%; P=0.057).