PMID- 34660317
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220427
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 11
DP  - 2021
TI  - Direct Comparison Between the Addition of Pembrolizumab or Bevacizumab for 
      Chemotherapy-Based First-Line Treatment of Advanced Non-Squamous Non-Small Cell 
      Lung Cancer Lacking Driver Mutations.
PG  - 752545
LID - 10.3389/fonc.2021.752545 [doi]
LID - 752545
AB  - BACKGROUND: The addition of bevacizumab or pembrolizumab to pemetrexed-platinum 
      chemotherapy has produced significant clinical benefits to patients with 
      untreated, advanced non-squamous non-small cell lung cancer (NSCLC) lacking 
      targetable genetic aberrations. However, the direct comparison between these two 
      first-line treatments needs to be investigated. METHODS: We retrospectively 
      investigated the medical records of 102 patients with stage IIIB~IV non-squamous 
      NSCLC, and without sensitizing EGFR/ALK/ROS1 alterations. All patients received 
      pembrolizumab or bevacizumab plus pemetrexed-platinum chemotherapy as the 
      first-line treatment between December 2018 to April 2021 at Fudan University 
      Shanghai Cancer Center. Assessments included progression-free survival (PFS), 
      overall survival (OS), objective response rate (ORR), disease control rate (DCR), 
      and adverse events (AEs). We also evaluated the prognostic biomarkers in the 
      overall population and explored potential predictive biomarkers to aid the 
      selection of optimal treatment regimens. RESULTS: The median PFS was 10.0 months 
      in the pembrolizumab group and 9.2 months in bevacizumab group (HR = 1.006; P = 
      0.982), while the median OS was not reached in either group (HR= 1.193; P 
      =0.714). ORR was 36.7% versus 43.4% (P = 0.548) and DCR was 89.8% versus 92.5% (P 
      = 0.735) in the pembrolizumab and bevacizumab groups, respectively. In the 
      overall study population, baseline lymphocyte to monocyte ratio (LMR) >1.95 (HR = 
      0.312, P < 0.001) was an indicator of longer PFS. The presence of baseline bone 
      metastasis (HR = 4.107, P = 0.009), baseline lactate dehydrogenase (LDH) >300 U/L 
      (HR = 4.300, P = 0.025) and LMR </=1.95 (HR = 5.291, P = 0.039) were associated 
      with inferior OS. Baseline neutrophil-to-lymphocyte ratio (NLR) </=3.10 was 
      predictive of significantly favorable OS in the bevacizumab combination treatment 
      (HR = 5.073, P = 0.039). The safety profiles were generally comparable between 
      the two groups. CONCLUSIONS: In patients with chemotherapy-naive, advanced, 
      non-squamous NSCLC who lack driver mutations, the efficacy and safety of 
      pembrolizumab and bevacizumab when combined with pemetrexed-platinum were 
      comparable. For patients with baseline NLR </=3.10, the bevacizumab combination 
      therapy elicited significantly better OS benefits.
CI  - Copyright (c) 2021 Liao, Liu, Long, Wu, Wang, Yu, Sun, Zhang, Lin, Zhao and Wang.
FAU - Liao, Jiatao
AU  - Liao J
AD  - Department of Medical Oncology, Fudan University Shanghai Cancer Center, 
      Shanghai, China.
AD  - Department of Oncology, Shanghai Medical College of Fudan University, Shanghai, 
      China.
FAU - Liu, Chang
AU  - Liu C
AD  - Department of Medical Oncology, Fudan University Shanghai Cancer Center, 
      Shanghai, China.
AD  - Department of Oncology, Shanghai Medical College of Fudan University, Shanghai, 
      China.
FAU - Long, Qianqian
AU  - Long Q
AD  - Department of Medical Oncology, Fudan University Shanghai Cancer Center, 
      Shanghai, China.
AD  - Department of Oncology, Shanghai Medical College of Fudan University, Shanghai, 
      China.
FAU - Wu, Xianghua
AU  - Wu X
AD  - Department of Medical Oncology, Fudan University Shanghai Cancer Center, 
      Shanghai, China.
AD  - Department of Oncology, Shanghai Medical College of Fudan University, Shanghai, 
      China.
FAU - Wang, Huijie
AU  - Wang H
AD  - Department of Medical Oncology, Fudan University Shanghai Cancer Center, 
      Shanghai, China.
AD  - Department of Oncology, Shanghai Medical College of Fudan University, Shanghai, 
      China.
FAU - Yu, Hui
AU  - Yu H
AD  - Department of Medical Oncology, Fudan University Shanghai Cancer Center, 
      Shanghai, China.
AD  - Department of Oncology, Shanghai Medical College of Fudan University, Shanghai, 
      China.
FAU - Sun, Si
AU  - Sun S
AD  - Department of Medical Oncology, Fudan University Shanghai Cancer Center, 
      Shanghai, China.
AD  - Department of Oncology, Shanghai Medical College of Fudan University, Shanghai, 
      China.
FAU - Zhang, Yao
AU  - Zhang Y
AD  - Department of Medical Oncology, Fudan University Shanghai Cancer Center, 
      Shanghai, China.
AD  - Department of Oncology, Shanghai Medical College of Fudan University, Shanghai, 
      China.
FAU - Lin, Ying
AU  - Lin Y
AD  - Department of Medical Oncology, Fudan University Shanghai Cancer Center, 
      Shanghai, China.
AD  - Department of Oncology, Shanghai Medical College of Fudan University, Shanghai, 
      China.
FAU - Zhao, Xinmin
AU  - Zhao X
AD  - Department of Medical Oncology, Fudan University Shanghai Cancer Center, 
      Shanghai, China.
AD  - Department of Oncology, Shanghai Medical College of Fudan University, Shanghai, 
      China.
FAU - Wang, Jialei
AU  - Wang J
AD  - Department of Medical Oncology, Fudan University Shanghai Cancer Center, 
      Shanghai, China.
AD  - Department of Oncology, Shanghai Medical College of Fudan University, Shanghai, 
      China.
LA  - eng
PT  - Journal Article
DEP - 20210929
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC8511673
OTO - NOTNLM
OT  - bevacizumab
OT  - biomarker
OT  - first-line treatment
OT  - non-small-cell lung cancer
OT  - pembrolizumab
OT  - pemetrexed
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2021/10/19 06:00
MHDA- 2021/10/19 06:01
PMCR- 2021/01/01
CRDT- 2021/10/18 09:06
PHST- 2021/08/03 00:00 [received]
PHST- 2021/09/06 00:00 [accepted]
PHST- 2021/10/18 09:06 [entrez]
PHST- 2021/10/19 06:00 [pubmed]
PHST- 2021/10/19 06:01 [medline]
PHST- 2021/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2021.752545 [doi]
PST - epublish
SO  - Front Oncol. 2021 Sep 29;11:752545. doi: 10.3389/fonc.2021.752545. eCollection 
      2021.