A treatment approach approved by the FDA in 2006 which involves adding the drug bevacizumab (Avastin) to the standard chemotherapy regimen for non–small cell lung cancer (NSCLC) did not significantly increase survival rates for patients over the age of 65 enrolled in Medicare, according to a new study being published in the April 18 issue of JAMA.
The study’s senior author, Deborah Schrag, MD, MPH, of Dana-Farber Cancer Institute, explains the study’s results. “First, we found that bevacizumab was not universally adopted after its FDA approval. Second, the addition of bevacizumab did not provide any substantial survival advantage when added to standard chemotherapy.”
According to the study authors, a previous trial determined that adding bevacizumab to the standard NSCLC 2-drug treatment (carboplatin and paclitaxel) improved survival in many patients with advanced disease, but not those aged 65 years or older.
In the new study, Schrag and colleagues evaluated survival rates in 3 groups of patients: patients who received bevacizumab-carboplatin-paclitaxel therapy, patients who received carboplatin-paclitaxel therapy in 2006-2007, and patients who received carboplatin-paclitaxel therapy in 2002-2005.
Researchers discovered that the median overall survival was 9.7 months for patients receiving the 3-drug combination compared with 8.9 months and 8.0 months for the 2006-2007 and the 2002-2005 standard-therapy groups, respectively. Furthermore, the probability of surviving for 1 year was not significantly different among the 3 groups. For those in the 3-drug group, the probability was 39.6%, compared with 40.1% for the 2006-2007 standard-therapy group, and 35.6% for the 2002-2005 standard-therapy group. Thus, the authors did not find a significant difference in overall survival between patients treated with standard therapy plus bevacizumab and those treated only with the standard 2-drug chemotherapy. Based on these results, the authors advocate physicians cautiously recommend the use of bevacizumab.
Source: Dana-Farber Cancer Institute.