ECOG 4599 PDF

to paclitaxel/carboplatin, prolongs survival in previously untreated patients with advanced non-small-cell lung cancer: preliminary results from the ECOG Lung Cancer: Secondary Analyses of the ECOG and PointBreak Trials. Eastern Cooperative Oncology Group (E) and PointBreak studies. ECOG demonstrated longer progression-free (PFS) and overall survival ( OS) with the addition of bevacizumab at a dose of 15 mg/m2.

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Rates of clinically significant bleeding were ecoy. Weekly paclitaxel, carboplatin, cetuximab, and cetuximab, docetaxel, cisplatin, and fluorouracil, followed by local therapy in previously untreated, locally advanced head and neck squamous cell carcinoma. This strategy has been only marginally successful. The primary end point was overall survival.

The median progression-free survival in the two groups was 6. Clinical experience has generally been less favorable in gemcitabine-based trials [ 1920 ].

What did we know regarding bevacizumab before this meta-analysis and what new information has it provided? Subset analysis suggested that older patients derived no benefit from the addition of bevacizumab [ 10 ].

Prognostic significance of angiogenesis and angiogenic growth factors in nonsmall cell lung cancer. Currently, ECOG is comparing maintenance bevacizumab with pemetrexed versus the combination and this study should establish the relative contributions of these two agents to improving survival [ 22 ].

Recently, two additional randomized trials have provided us with new data on bevacizumab. Oxford University Press is a department of the University of Oxford.

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Erratum in N Engl J Med. This would tend to push both HRs toward one. While more clinical data on the role of pemetrexed combined with bevacizumab and its contribution to maintenance will be needed, there appears to be little justification at this time to consider its addition to a pemetrexed-based regimen as a standard. The role of bevacizumab in the maintenance setting remains unclear. A number of other anti-angiogenic agents have been investigated in advanced stage NSCLC without success.

Three of the trials used a paclitaxel Taxol -based regimen and one used gemcitabine.

Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer.

The broad conclusion that bevacizumab can be added to doublet chemotherapy with a survival benefit seems exaggerated, given that only two specific doublets were examined, one in patients who would no longer be offered the drug i. Is the conclusion that bevacizumab added to any platinum-based chemotherapy prolongs survival supported by these data?

Of interest, Zhu et al. Patients on the bevacizumab arm also received maintenance bevacizumab; however, the relative value of its administration with chemotherapy or as single-agent maintenance remains unknown since the two individual study components were not separately evaluated.

Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer.

Exploratory analysis suggested that the doublet maintenance arm might be superior in patients who continued on trial during the maintenance treatment phase, a finding which is consistent with data from other pemetrexed-based maintenance chemotherapy trials [ 2 ]. Bevacizumab remains of interest in the adjuvant setting as currently investigated in ECOG Evidence-based role of bevacizumab in non-small cell lung cancer E.

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Two randomized phase II studies 459 also included in the meta-analysis and evaluated bevacizumab added to paclitaxel [ 1314 ]. One of these JO reached statistical significance in favor of the addition of bevacizumab for the PFS end point [ 14 ]. All the remaining authors have declared no conflicts of interest. A study of docetaxel with or without vandetanib showed a PFS benefit, whereas there was no significant difference in PFS with pemetrexed [ 2324 ].

In ecgo initial publication, survival was not reported and increased PFS for the lower-dose arm was demonstrated [ 11 ]. However, until data provide evidence to the contrary it can be hypothesized that a pemetrexed-based doublet would be equivalent to the carboplatin, paclitaxel, bevacizumab triplet [ 115 ].

It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. Synergy of nab-paclitaxel and bevacizumab in eradicating large orthotopic breast tumors and preexisting metastases.

Randomized phase II trial comparing bevacizumab plus carboplatin and paclitaxel with carboplatin and paclitaxel alone in previously untreated locally advanced or metastatic non-small-cell lung cancer.

Chemotherapy was administered every 3 weeks for six cycles, and bevacizumab was administered every 3 weeks until disease progression was evident or toxic effects were eckg. Thus, the trial investigated the addition of bevacizumab to a sub-optimal doublet base for its target patient population.