EGFR-TKI plus bevacizumab as maintenance therapy for advanced lung adenocarcinoma: a retrospective study of 192 cases

Abstract

Objective To compare the efficacy and safety of EGFR-TKI plus bevacizumab as maintenance therapy with EGFR-TKI alone for EGFR-mutated advanced lung adenocarcinoma. Methods Clinical data of 192 patients with advanced lung adenocarcinoma admitted in our hospital from 2013 to 2019 were collected and retrospectively analyzed. Thirty of them received combination therapy (EGFR-TKI plus bevacizumab as maintenance therapy), and the other 162 monotherapy (continuous treatment with EGFR-TKI until disease progression). Then 29 pairs of patients were matched by propensity score matching at a ratio of 1∶1. Overall progression-free survival (PFS1), PFS after reaching stable disease (PFS2), duration of response (DoR), objective response rate (ORR), tumor size changes and safety profiles were compared between the 2 groups. Results The combination group had significantly longer median PFS1 (17.3 vs 11.5 months, HR=0.401, P=0.001) and PFS2 (6.0 vs 3.9 months, HR=0.527, P=0.023), and also statistically longer median DoR (12.2 vs 8.6 months, HR=0.503, P=0.037) when compared with the monotherapy group.The ORR was 79.3% and 72.4%, respectively, with no statistical difference but the reduction in target tumor lesion size was greater in the combination group. No treatment-associated death occurred in both groups. Common advance events were skin and mucous damage (55% vs 62%), hepatic function damage (55% vs 45%), renal function damage (17% vs 7%) and hypertension (10% vs 0). The rate of grade 3 or worse adverse events were 14% versus 7% in the 2 groups (P>0.05). Conclusion EGFR-TKI plus bevacizumab is superior to EGFR-TKI monotherapy with more effective maintenance therapy and tolerable toxicity.

Keywords

• lung adenocarcinoma
• egfr mutation
• tyrosine kinase inhibitor
• bevacizumab
• maintenance therapy