Bevacizumab for the treatment of nonsquamous non-small-cell lung cancer in Portugal: a retrospective, multicenter study

Abstract

Fernanda Estevinho1, Marta Soares2, Isabel Azevedo2, Henrique Queiroga3, Bárbara Parente4, Ulisses Brito5, Encarnação Teixeira6, Renato Sotto-Mayor7, António Araújo81Medical Oncology Resident, Department of Medical Oncology, Portuguese Institute of Oncology, Oporto Center, Oporto, Portugal; 2Medical Oncology Assistant, Department of Medical Oncology, Portuguese Institute of Oncology, Oporto Center, Oporto, Portugal; 3Coordinator of the Oncological Pneumology Consultation, Pneumology Departament of Hospital S João, Oporto, Portugal; 4Director of Pneumology Department, Pneumology Department, Vila Nova de Gaia-Espinho Medical Center, Vila Nova de Gaia, Portugal; 5Director of Pneumology Department, Pneumology Department, Faro Hospital, Faro, Portugal; 6Pneumology assistant, Pneumology Department I, Hospital Santa Maria – Lisbon North Hospital Center, Lisbon, Portugal; 7Head of Service of Pneumology, Pneumology Department I, Hospital Santa Maria – Lisbon North Hospital Center, Lisbon, Portugal; 8Coordinator of Lung Pathology Clinic, Department of Medical Oncology, Portuguese Institute of Oncology, Oporto Center, Oporto, PortugalIntroduction: Lung cancer is the leading cause of cancer-related mortality. In patients with nonsquamous non-small-cell lung cancer (NSCLC) stage IIIB/IV treatment with chemotherapy plus bevacizumab led to significant improvements in progression-free and median overall survival (OS).Aim: To report the experience of five Portuguese centers in treating patients with nonsquamous NSCLC in stage IIIB or IV with bevacizumab and chemotherapy regarding survival and toxicity outcomes.Materials and methods: This was a retrospective, multicenter study on patients with nonsquamous stage IIIB/IV NSCLC treated with bevacizumab and chemotherapy from November 2007 to August 2010 through special use permits. We reviewed the medical records, registry of demographic characteristics, treatments provided, treatment responses, adverse events, and dates of death. Statistical analysis was performed with SPSS statistics software. Median OS and event-free survival (EFS) were calculated using the Kaplan–Meier method.Results: From an eligible population of 41 patients, 37 participants were registered. Study participants were predominantly male (78.4%) with a median age of 53 years (29–75 years). In total, 83.8% patients had stage IV disease (TNM, 6th Ed.). The OS was 21.5 months (95% confidence interval [CI]: 12.6–30.5] and median EFS was 9.4 months (95% CI9: 7.1–11.7). Hematologic toxicity grade 3/4 occurred in 35.1% of patients, and nonhematologic toxicity in 24.3% patients. One fatal thromboembolic event was recorded (2.7%).Conclusions: The results of chemotherapy plus bevacizumab treatment for nonsquamous NSCLC obtained from the daily clinical practice of the centers involved in this study were similar to those of published clinical trials. Collaboration between the different Portuguese centers is crucial for this kind of study.Keywords: lung neoplasms, carcinoma, non-small-cell lung, nonsquamous, bevacizumab, angiogenesis inhibitors