Overall survival with cisplatin-gemcitabine and bevacizumab or placebo as first-line therapy for nonsquamous non-small-cell lung cancer: results from a randomised phase III trial (AVAiL)

Background - Bevacizumab, the anti-vascular endothelial growth factor agent, provides clinical benefit when combined with platinum-based chemotherapy in first-line advanced non-small-cell lung cancer. We report the final overall survival (OS) analysis from the phase III AVAiL trial. - Patients and m...

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Main Authors: Reck, Martin (Author) , von Pawel, J. (Author) , Zatloukal, P. (Author) , Ramlau, R. (Author) , Gorbounova, V. (Author) , Hirsh, V. (Author) , Leighl, N. (Author) , Mezger, J. (Author) , Archer, V. (Author) , Moore, N. (Author) , Manegold, Christian (Author)
Format: Article (Journal)
Language:English
Published: September 2010
In: Annals of oncology
Year: 2010, Volume: 21, Issue: 9, Pages: 1804-1809
ISSN:1569-8041
DOI:10.1093/annonc/mdq020
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1093/annonc/mdq020
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0923753419400471
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Author Notes:M. Reck, J. von Pawel, P. Zatloukal, R. Ramlau, V. Gorbounova, V. Hirsh, N. Leighl, J. Mezger, V. Archer, N. Moore, C. Manegold & BO17704 Study Group
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Summary:Background - Bevacizumab, the anti-vascular endothelial growth factor agent, provides clinical benefit when combined with platinum-based chemotherapy in first-line advanced non-small-cell lung cancer. We report the final overall survival (OS) analysis from the phase III AVAiL trial. - Patients and methods - Patients (n=1043) received cisplatin 80 mg/m2 and gemcitabine 1250 mg/m2 for up to six cycles plus bevacizumab 7.5 mg/kg (n=345), bevacizumab 15 mg/kg (n=351) or placebo (n=347) every 3 weeks until progression. Primary end point was progression-free survival (PFS); OS was a secondary end point. - Results - Significant PFS prolongation with bevacizumab compared with placebo was maintained with longer follow-up {hazard ratio (HR) [95% confidence interval (CI)] 0.75 (0.64-0.87), P=0.0003 and 0.85 (0.73-1.00), P=0.0456} for the 7.5 and 15 mg/kg groups, respectively. Median OS was >13 months in all treatment groups; nevertheless, OS was not significantly increased with bevacizumab [HR (95% CI) 0.93 (0.78-1.11), P=0.420 and 1.03 (0.86-1.23), P=0.761] for the 7.5 and 15 mg/kg groups, respectively, versus placebo. Most patients (∼62%) received multiple lines of poststudy treatment. Updated safety results are consistent with those previously reported. - Conclusions - Final analysis of AVAiL confirms the efficacy of bevacizumab when combined with cisplatin-gemcitabine. The PFS benefit did not translate into a significant OS benefit, possibly due to high use of efficacious second-line therapies.
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ISSN:1569-8041
DOI:10.1093/annonc/mdq020