PMID- 33592829
OWN - NLM
STAT- MEDLINE
DCOM- 20210303
LR  - 20230103
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 100
IP  - 5
DP  - 2021 Feb 5
TI  - Efficacy of epidermal growth factor receptor tyrosine kinase inhibitors 
      (EGFR-TKIs) combined with bevacizumab for advanced non-squamous non-small-cell 
      lung cancer patients with gradual progression on EGFR-TKI treatment: A cohort 
      study.
PG  - e23712
LID - 10.1097/MD.0000000000023712 [doi]
LID - e23712
AB  - Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) 
      significantly improve outcomes of patients with EGFR-mutated non-small-cell lung 
      cancer (NSCLC). However, acquired resistance inevitably emerges and remains a 
      major challenge. The present study aimed to evaluate the efficacy of EGFR-TKIs 
      plus bevacizumab in advanced non-squamous NSCLC patients with gradual progression 
      on EGFR-TKIs.Advanced non-squamous EGFR-mutated NSCLC patients with gradual 
      progression on EGFR-TKIs were administered bevacizumab while EGFR-TKIs were 
      continued until disease progression occurred. Tumor lesions were assessed, and 
      blood samples were collected at the start of the combination treatment and every 
      6 weeks until disease progression.Among the 15 included patients, there were no 
      grade 3 or higher adverse events (AEs). Partial response (PR) and stable disease 
      (SD) were achieved in 1 and 13 patients, respectively, with an objective response 
      rate (ORR) of 6.7% and a disease control rate (DCR) of 93.3%. The median 
      progression-free survival 2 (PFS2), defined as the time from the initiation of 
      combination treatment to disease progression, was 5.0 (95% confidence interval 
      [CI]: 4.0-6.0) months. Additionally, Spearman correlation analysis revealed that 
      PFS2 was positively correlated with the serum vascular endothelial growth factor 
      (VEGF) level at baseline (r = 0.7212, P = .0234). Patients with high baseline 
      serum VEGF levels showed a better median PFS2 than those with low baseline serum 
      VEGF levels (5.5 months vs 3.6 months, P = .0333).EGFR-TKIs plus bevacizumab led 
      to a durable prolongation of PFS in non-squamous NSCLC patients with gradual 
      progression on EGFR-TKIs. This therapeutic regimen was well tolerated and could 
      be a promising strategy for these patients. Serum VEGF could be a potential 
      biomarker to predict a subset of patients who are likely to benefit from 
      EGFR-TKIs combined with bevacizumab.
CI  - Copyright (c) 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Yu, Yuman
AU  - Yu Y
AD  - Department of Respiratory Disease, The First Affiliated Hospital, College of 
      Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
FAU - Wang, Yuehong
AU  - Wang Y
FAU - Wu, Linying
AU  - Wu L
FAU - Xu, Xuanli
AU  - Xu X
FAU - Zhou, Hua
AU  - Zhou H
FAU - Wang, Qing
AU  - Wang Q
FAU - Zhou, Jianying
AU  - Zhou J
AUID- ORCID: 0000-0002-8924-935
LA  - eng
GR  - 81670017/National Natural Science Foundation of China/
GR  - 2019C03042/the Key Project of Science Technology Department of Zhejiang Province, 
      China/
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Antineoplastic Agents, Immunological)
RN  - 0 (Protein Kinase Inhibitors)
RN  - 2S9ZZM9Q9V (Bevacizumab)
RN  - EC 2.7.10.1 (ErbB Receptors)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Agents, Immunological/administration & dosage/adverse 
      effects/*therapeutic use
MH  - Antineoplastic Combined Chemotherapy Protocols
MH  - Bevacizumab/administration & dosage/adverse effects/*therapeutic use
MH  - Carcinoma, Non-Small-Cell Lung/*drug therapy
MH  - Disease-Free Survival
MH  - ErbB Receptors/antagonists & inhibitors
MH  - Female
MH  - Humans
MH  - Lung Neoplasms/*drug therapy/pathology
MH  - Male
MH  - Middle Aged
MH  - Protein Kinase Inhibitors/administration & dosage/adverse effects/*therapeutic 
      use
PMC - PMC7870213
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2021/02/18 06:00
MHDA- 2021/03/04 06:00
PMCR- 2021/02/05
CRDT- 2021/02/17 01:02
PHST- 2020/08/06 00:00 [received]
PHST- 2020/11/16 00:00 [accepted]
PHST- 2021/02/17 01:02 [entrez]
PHST- 2021/02/18 06:00 [pubmed]
PHST- 2021/03/04 06:00 [medline]
PHST- 2021/02/05 00:00 [pmc-release]
AID - 00005792-202102050-00016 [pii]
AID - MD-D-20-07852 [pii]
AID - 10.1097/MD.0000000000023712 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2021 Feb 5;100(5):e23712. doi: 10.1097/MD.0000000000023712.