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Article: Clinical efficacy and safety of pemetrexed with or without either Bevacizumab or Pembrolizumab in patients with metastatic nonsquamous non–small cell carcinoma

TitleClinical efficacy and safety of pemetrexed with or without either Bevacizumab or Pembrolizumab in patients with metastatic nonsquamous non–small cell carcinoma
Authors
Keywordsbevacizumab
lung cancer
pembrolizumab
pemetrexed
Issue Date2022
Citation
Asia-Pacific Journal of Clinical Oncology, 2022 How to Cite?
AbstractBackground: Pemetrexed was approved by United States Food and Drug Administration (US FDA) in combination with platinum for the treatment of advanced nonsquamous non–small cell lung carcinoma (NSCLC) and malignant mesothelioma. Bevacizumab and pembrolizumab can be added to chemotherapy for patients with nonsquamous NSCLC with benefits but there has not been any dedicated head-to-head comparison between pembrolizumab-pemetrexed-platinum (PAC) and bevacizumab-pemetrexed-platinum (BAC) on their efficacy and safety. Methods: This was a retrospective single-center cohort study conducted in Queen Mary Hospital in Hong Kong. The study included 451 patients with advanced stage nonsquamous NSCLC that received first-line pemetrexed and platinum with or without bevacizumab or pembrolizumab. Patients who received pemetrexed-platinum (AC) were compared with those who received PAC and BAC. The primary endpoint was the progression-free survival (PFS). Results: The median PFS for patients that received PAC was significantly longer than those who received BAC and AC (9 months vs. 6.8 months vs. 4.8 months, p < 0.05 among all three groups), with OR of 0.578 (95% CI, 0.343–0.976; p = 0.040) and 0.430 (95% CI, 0.273–0.675; p < 0.001) when compared to BAC and AC, respectively. Patients who received PAC also had a higher disease control rate and higher likelihood to receive continuation maintenance therapy than those on AC. There is no statistically significant difference in the grade 3 to 4 toxicity among the three treatment groups. Conclusions: Although both regimens are superior to pemetrexed-platinum alone, data from this retrospective single center study suggested a better PFS in advanced stage nonsquamous NSCLC patient treated with first-line pembrolizumab-pemetrexed-platinum than bevacizumab-pemetrexed-platinum without an obvious increase in significant toxicity.
Persistent Identifierhttp://hdl.handle.net/10722/315394
ISSN
2023 Impact Factor: 1.4
2023 SCImago Journal Rankings: 0.531
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorKwok, Wang Chun-
dc.contributor.authorCheong, Tan Fong-
dc.contributor.authorChiang, Ka Yan-
dc.contributor.authorHo, James Chung Man-
dc.contributor.authorLam, David Chi Leung-
dc.contributor.authorIp, Mary Sau Man-
dc.contributor.authorTam, Terence Chi Chun-
dc.date.accessioned2022-08-05T10:18:44Z-
dc.date.available2022-08-05T10:18:44Z-
dc.date.issued2022-
dc.identifier.citationAsia-Pacific Journal of Clinical Oncology, 2022-
dc.identifier.issn1743-7555-
dc.identifier.urihttp://hdl.handle.net/10722/315394-
dc.description.abstractBackground: Pemetrexed was approved by United States Food and Drug Administration (US FDA) in combination with platinum for the treatment of advanced nonsquamous non–small cell lung carcinoma (NSCLC) and malignant mesothelioma. Bevacizumab and pembrolizumab can be added to chemotherapy for patients with nonsquamous NSCLC with benefits but there has not been any dedicated head-to-head comparison between pembrolizumab-pemetrexed-platinum (PAC) and bevacizumab-pemetrexed-platinum (BAC) on their efficacy and safety. Methods: This was a retrospective single-center cohort study conducted in Queen Mary Hospital in Hong Kong. The study included 451 patients with advanced stage nonsquamous NSCLC that received first-line pemetrexed and platinum with or without bevacizumab or pembrolizumab. Patients who received pemetrexed-platinum (AC) were compared with those who received PAC and BAC. The primary endpoint was the progression-free survival (PFS). Results: The median PFS for patients that received PAC was significantly longer than those who received BAC and AC (9 months vs. 6.8 months vs. 4.8 months, p < 0.05 among all three groups), with OR of 0.578 (95% CI, 0.343–0.976; p = 0.040) and 0.430 (95% CI, 0.273–0.675; p < 0.001) when compared to BAC and AC, respectively. Patients who received PAC also had a higher disease control rate and higher likelihood to receive continuation maintenance therapy than those on AC. There is no statistically significant difference in the grade 3 to 4 toxicity among the three treatment groups. Conclusions: Although both regimens are superior to pemetrexed-platinum alone, data from this retrospective single center study suggested a better PFS in advanced stage nonsquamous NSCLC patient treated with first-line pembrolizumab-pemetrexed-platinum than bevacizumab-pemetrexed-platinum without an obvious increase in significant toxicity.-
dc.languageeng-
dc.relation.ispartofAsia-Pacific Journal of Clinical Oncology-
dc.subjectbevacizumab-
dc.subjectlung cancer-
dc.subjectpembrolizumab-
dc.subjectpemetrexed-
dc.titleClinical efficacy and safety of pemetrexed with or without either Bevacizumab or Pembrolizumab in patients with metastatic nonsquamous non–small cell carcinoma-
dc.typeArticle-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/ajco.13658-
dc.identifier.scopuseid_2-s2.0-85128380222-
dc.identifier.eissn1743-7563-
dc.identifier.isiWOS:000783963900001-

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