PMID- 24101054
OWN - NLM
STAT- MEDLINE
DCOM- 20131231
LR  - 20220331
IS  - 1527-7755 (Electronic)
IS  - 0732-183X (Linking)
VI  - 31
IP  - 31
DP  - 2013 Nov 1
TI  - ATLAS: randomized, double-blind, placebo-controlled, phase IIIB trial comparing 
      bevacizumab therapy with or without erlotinib, after completion of chemotherapy, 
      with bevacizumab for first-line treatment of advanced non-small-cell lung cancer.
PG  - 3926-34
LID - 10.1200/JCO.2012.47.3983 [doi]
AB  - PURPOSE: This phase III trial was performed to assess the potential benefit of 
      adding maintenance erlotinib to bevacizumab after a first-line chemotherapy 
      regimen with bevacizumab for advanced non-small-cell lung cancer (NSCLC). 
      PATIENTS AND METHODS: One thousand one hundred forty-five patients with 
      histologically or cytologically confirmed NSCLC (stage IIIB with malignant 
      pleural effusion, stage IV, or recurrent) received four cycles of chemotherapy 
      plus bevacizumab. Seven hundred forty-three patients without disease progression 
      or significant toxicity were then randomly assigned (1:1) to bevacizumab (15 
      mg/kg, day 1, 21-day cycle) plus either placebo or erlotinib (150 mg per day). 
      The primary end point was progression-free survival (PFS). RESULTS: Median PFS 
      from time of random assignment was 3.7 months with bevacizumab/placebo and 4.8 
      months with bevacizumab/erlotinib (hazard ratio [HR], 0.71; 95% CI, 0.58 to 0.86; 
      P < .001). Median overall survival (OS) times from random assignment were 13.3 
      and 14.4 months with bevacizumab/placebo and bevacizumab/erlotinib, respectively 
      (HR, 0.92; 95% CI, 0.70 to 1.21; P = .5341). During the postchemotherapy phase, 
      there were more adverse events (AEs) overall, more grade 3 and 4 AEs (mainly rash 
      and diarrhea), more serious AEs, and more AEs leading to erlotinib/placebo 
      discontinuation in the bevacizumab/erlotinib arm versus the bevacizumab/placebo 
      arm. The incidence of AEs leading to bevacizumab discontinuation was similar in 
      both treatment arms. CONCLUSION: The addition of erlotinib to bevacizumab 
      significantly improved PFS but not OS. Although generally well tolerated, the 
      modest impact on survival and increased toxicity associated with the addition of 
      erlotinib to bevacizumab maintenance mean that this two-drug maintenance regimen 
      will not lead to a new postchemotherapy standard of care.
FAU - Johnson, Bruce E
AU  - Johnson BE
AD  - Bruce E. Johnson, Dana-Farber Cancer Institute, Boston, MA; Fairooz Kabbinavar, 
      University of California Los Angeles, Translational Oncology Research 
      International, Los Angeles; Louis Fehrenbacher, Kaiser Permanente Northern 
      California, Vallejo; Chin-Yu Lin and Chris Bowden, Genentech, South San 
      Francisco; Jonathan Polikoff, Southern California Permanente Medical Group, San 
      Diego, CA; John Hainsworth, Sarah Cannon Research Institute, Nashville, TN; 
      Saifuddin Kasubhai, Northwest Medical Specialties, Tacoma, WA; Bruce Kressel, 
      Sibley Memorial Hospital, Washington, DC; Thomas Marsland, Integrated Community 
      Oncology Network, Orange Park; Mark Rubin, Florida Cancer Specialists, Fort 
      Myers, FL; Taral Patel, The Mark H. Zangmeister Center, Columbus, OH; Leonard 
      White, Arch Medical Services, The Center for Cancer Care and Research, Saint 
      Louis, MO; Vincent Miller, Weill Cornell Medical College and Thoracic Oncology 
      Service, Memorial Sloan-Kettering Cancer Center, New York, NY; and James 
      Chih-Hsin Yang, National Taiwan University, Taipei, Taiwan.
FAU - Kabbinavar, Fairooz
AU  - Kabbinavar F
FAU - Fehrenbacher, Louis
AU  - Fehrenbacher L
FAU - Hainsworth, John
AU  - Hainsworth J
FAU - Kasubhai, Saifuddin
AU  - Kasubhai S
FAU - Kressel, Bruce
AU  - Kressel B
FAU - Lin, Chin-Yu
AU  - Lin CY
FAU - Marsland, Thomas
AU  - Marsland T
FAU - Patel, Taral
AU  - Patel T
FAU - Polikoff, Jonathan
AU  - Polikoff J
FAU - Rubin, Mark
AU  - Rubin M
FAU - White, Leonard
AU  - White L
FAU - Yang, James Chih-Hsin
AU  - Yang JC
FAU - Bowden, Chris
AU  - Bowden C
FAU - Miller, Vincent
AU  - Miller V
LA  - eng
SI  - ClinicalTrials.gov/NCT00257608
PT  - Clinical Trial, Phase III
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20131007
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Quinazolines)
RN  - 2S9ZZM9Q9V (Bevacizumab)
RN  - DA87705X9K (Erlotinib Hydrochloride)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antibodies, Monoclonal, Humanized/*administration & dosage/adverse effects
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Bevacizumab
MH  - Carcinoma, Non-Small-Cell Lung/*drug therapy/mortality
MH  - Disease-Free Survival
MH  - Double-Blind Method
MH  - Erlotinib Hydrochloride
MH  - Female
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Lung Neoplasms/*drug therapy/mortality
MH  - Maintenance Chemotherapy/*methods
MH  - Male
MH  - Middle Aged
MH  - Proportional Hazards Models
MH  - Quinazolines/*administration & dosage/adverse effects
MH  - Treatment Outcome
EDAT- 2013/10/09 06:00
MHDA- 2014/01/01 06:00
CRDT- 2013/10/09 06:00
PHST- 2013/10/09 06:00 [entrez]
PHST- 2013/10/09 06:00 [pubmed]
PHST- 2014/01/01 06:00 [medline]
AID - JCO.2012.47.3983 [pii]
AID - 10.1200/JCO.2012.47.3983 [doi]
PST - ppublish
SO  - J Clin Oncol. 2013 Nov 1;31(31):3926-34. doi: 10.1200/JCO.2012.47.3983. Epub 2013 
      Oct 7.