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Association details:
| Biomarker: | EGFR mutation |
|---|---|
| Cancer: | Non Small Cell Lung Cancer |
| Drug: | Avastin (bevacizumab) (VEGF-A inhibitor) |
| Direction: | Sensitive |
Evidence:
Source:
Published date:
09/15/2020
Excerpt:
The NCCN NSCLC Panel recommends the following systemic therapy regimens as options for certain patients with metastatic NSCLC,…bevacizumab (category 2B) for EGFR mutation-positive metastatic disease...
Source:
Title:
Metastatic non-small cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
Excerpt:
First-line treatment of EGFR-mutated NSCLC: Erlotinib/bevacizumab represents a front-line treatment option in patients with EGFR-mutated tumours [II, B; ESMO-MCBS v1.1 score: 3].
DOI:
10.1093/annonc/mdy275
Source:
Title:
BEYOND: A Randomized, Double-Blind, Placebo-Controlled, Multicenter, Phase III Study of First-Line Carboplatin/Paclitaxel Plus Bevacizumab or Placebo in Chinese Patients With Advanced or Recurrent Nonsquamous Non-Small-Cell Lung Cancer
Published date:
07/01/2015
Excerpt:
Patients age ≥ 18 years with locally advanced, metastatic, or recurrent advanced nonsquamous non-small-cell lung cancer (NSCLC)...Median PFS was 12.4 months with B+CP and 7.9 months with Pl+CP (HR, 0.27; 95% CI, 0.12 to 0.63) in EGFR mutation-positive tumors and 8.3 and 5.6 months, respectively (HR, 0.33; 95% CI, 0.21 to 0.53), in wild-type tumors....The addition to bevacizumab to carboplatin/paclitaxel was well tolerated and resulted in a clinically meaningful treatment benefit in Chinese patients with advanced nonsquamous NSCLC.
Secondary therapy:
paclitaxel; carboplatin
DOI:
10.1200/JCO.2014.59.4424
Trial ID:
Source:
Title:
Effectiveness and Safety of Adding Bevacizumab to First Line Chemotherapy in Lung Cancer Patients With Stable Disease
Excerpt:
...EGFR(epidermal growth factor receptor) mutations, ALK(anaplastic lymphoma kinase) gene fusion, etc.) could be included; 5....
Trial ID:
Source:
Title:
Therapeutic Strategies in Patients With Non-squamous Non-small Cell Lung Cancer With Brain Metastases
Excerpt:
...Patients with histologically or cytologically proven non-epidermoid, non-small cell lung cancer, non-EGFR (Epidermal Growth Factor Receptor)-mutated (or mutation test impracticable)....
Trial ID:
More C2 evidence
Source:
Title:
Bevacizumab and Erlotinib in Lung Cancer With Brain Metastases, a Phase II Trial
Excerpt:
...- A tumor harboring an EGFR mutation known to be associated with erlotinib sensitivity (exon 19 deletion and L858R)...
Trial ID:
Source:
Title:
Gefitinib plus pemetrexed combined with bevacizumab or carboplatin in first-line treatment of stage IV EGFR mutant non-squamous non-small cell lung cancer.
Excerpt:
...EGFR mutation was positive (including 19del, L858R, g719a, g719c, G719S, l861q); 8. ...
Trial ID:
Source:
Title:
A randomized open-label phase 3 trial comparing bevacizumab + erlotinib vs erlotinib alone as first line treatment of patients with EGFR mutated advanced non squamous non small cell lung cancer. Studio randomizzato, in aperto, di fase 3, di confronto tra bevacizumab + erlotinib vs erlotinib in monoterapia come trattamento di prima linea di pazienti affetti da carcinoma del polmone non a piccole cellule ad istotipo non squamoso e mutazione attivante di EGFR
Excerpt:
...Activating epidermal growth factor receptor mutation (exon19 deletion or exon 21L858R mutation or other activating/sensitizing mutations, such as exon 21 L861Q,exon 18 G719S, G719A and G719C, exon 20 S768I and V769L). ...
Trial ID:
Source:
Title:
Efficacy and Safety of Ametinib Combined With Bevacizumab in First-line Treatment of Non-oligometastatic Advanced NSCLC With EGFR-mutations.
Excerpt:
...1) age ≥18 years and ≤75 years; 2) life expectancy of more than 3 months; 3) patients with advanced NSCLC who had histologic or cytological confirmation according to the International Association for the study of lung cancer and the American Joint Committee on Classification of Cancer, 8th edition TNM staging classification of lung cancer; 4) Eastern Cooperative Oncology Group (ECOG) physical status score of 0-1; 5) had not received any previous systemic anti-tumor therapy for advanced disease; if had received prior platinum-based adjuvant chemotherapy, neoadjuvant chemotherapy, and disease progression to stage IV, and had occurred > 6 months after the end of the last treatment, were eligible to participate in this clinical study; 6) had a positive EGFR mutation (including 19 DEL, L858R) confirmed by histiocytogenetic testing; 7) CT or MRI confirmed metastases of more than or equal to 2 organs or single organs > GT 3, and brain metastases included symptomatic, asymptomatic, and meningeal metastases 8) haematological adequacy: absolute neutrophil count ≥1.5 × 10^9 L, platelet count ≥100 × 10^9 L, and hemoglobin ≥90 g/L 9) liver adequacy: total bilirubin level ≤1.5 times the upper limit of normal, aspartate transaminase and Alanine transaminase levels ≤2.5 times the upper limit of normal 10) renal adequacy: defined as creatinine clearance rate ≥50 ml/min (Cockcroft-Gault formula) 11) clotting adequacy: international standard ratio (INR) or prothrombin time (PT)≤1.5 times the upper limit of normal; If the patient is receiving anticoagulant treatment, INR/PT should be within the range of anticoagulant drugs proposed; 12)Female patients need to use efficient contraception and continue for at least 180 days after discontinuing the trial treatment. ...
Trial ID:
Source:
Title:
Clinical study of gefitinib monotherapy versus gefitinib combined with bevacizumab for advanced NSCLC with positive EGFR 21L858R mutation
Excerpt:
...Histologically or cytologically confirmed non-squamous non-small cell lung cancer, and the use of NGS detection suggested an exon mutation in EGFR 21L858R. ...
Trial ID:
Source:
Title:
Bevacizumab, Pemetrexed Disodium, and Cisplatin or Erlotinib Hydrochloride and Bevacizumab in Treating Patients With Stage IV Non-Small Cell Lung Cancer. A Multicenter Phase II Trial Including Biopsy at Progression (BIO-PRO Trial).
Excerpt:
...- Must have EGFR-mutation status (mutated or wild type) confirmed by the central pathologist in Basel...
Trial ID:
Source:
Title:
A Study of Pemetrexed, Carboplatin and Bevacizumab in Participants With Nonsquamous Non-Small Cell Lung Cancer
Excerpt:
...Percentage of Participants With a Complete Response (CR) and Partial Response (PR) (Overall Response Rate)`Percentage of Participants With a Complete Response (CR), Partial Response (PR), and Stable Disease (SD) (Disease Control Rate)`Progression Free Survival Time`Time to Progressive Disease`Safety and Toxicity Profile of Study Treatments`Duration of Hospitalizations Per Participant`Number of Participants Who Received a Transfusion`Number of Participants Receiving Concomitant Medication`Change From Baseline in Participant Reported Outcomes as Assessed by the Functional Assessment of Cancer Therapy - General (FACT-G)`Change From Baseline in Participant Reported Outcomes as Assessed by the Functional Assessment of Cancer Therapy - Lung (FACT-L)`Change From Baseline in Participant Reported Outcomes as Assessed by the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group- Neurotoxicity (FACT/GOG-Ntx)`Pharmacokinetics (PK): Maximum Observed Drug Concentration (Cmax) for Pemetrexed`Pharmacokinetics (PK): Elimination Half-life (t1/2) for Pemetrexed`Pharmacokinetics (PK): Area Under the Concentration Time Curve From Zero to Infinity (AUC(0-∞)) for Pemetrexed`Pharmacokinetics (PK): Pemetrexed Clearance (CL)`Pharmacokinetics (PK): Maximum Observed Drug Concentration (Cmax) for Total (Bound and Unbound) Platinum and Unbound Platinum`Pharmacokinetics (PK): Elimination Half-life (t1/2) for Total (Bound and Unbound) Platinum and Unbound Platinum`Pharmacokinetics (PK): Area Under the Concentration Time Curve From Zero to Infinity (AUC(0-∞)) for Total (Bound and Unbound) Platinum and Unbound Platinum`Pharmacokinetics (PK): Platinum Clearance (CL) for Total (Bound and Unbound) and Unbound Forms`Pharmacokinetics (PK): Maximum Observed Drug Concentration (Cmax) for Bevacizumab`Pharmacokinetics (PK): Elimination Half-life (t1/2) for Bevacizumab`Pharmacokinetics (PK): Area Under the Concentration Time Curve From Zero to Infinity (AUC(0-∞)) Bevacizumab`Pharmacokinetics (PK): Bevacizumab Clearance (CL)`Translational Research: Number of Participants With Epidermal Growth Factor Receptor (EGFR) Mutations`Translational Research: Overall Survival (OS) Based on Nuclear Thyroid Transcription Factor-1 (TTF-1) Expression Regardless of Study Treatment`Translational Research: Overall Survival (OS) Based on Cytoplasmic and Nuclear Thymidylate Synthase (TS) Expression`Translational Research: Overall Survival (OS) Based on Cytoplasmic and Membrane Folate Receptor Alpha (FR-α) Expression...
Trial ID:
Source:
Title:
Maintenance Chemotherapy Versus Consolidative Stereotactic Body Radiation Therapy (SBRT) Plus Maintenance Chemotherapy for Stage IV Non-Small Cell Lung Cancer (NSCLC): A Randomized Phase II Trial
Excerpt:
...Patients receiving first-line erlotinib, crizotinib for EGFR mutant-positive or EML4-ALK positive NSCLC will be excluded....
Trial ID:
Source:
Title:
PD-1 antibody plus chemotherapy versus bevacizumab plus chemotherapy as first-line treatment for patients with PD-L1 negative and EGFR/ALK wild-type advanced or metastatic non-squamous non-small cell lung cancer : an open-label, randomised, multicentre phase 3 trial
Excerpt:
...the research center must be able to provide relevant documentation of the subjects' EGFR mutation and ALK fusion gene status, and all of them must be negative. ...
Trial ID:
Source:
Title:
Paclitaxel-Carboplatin-Bevacizumab +/- Nitroglycerin in Metastatic Non-Squamous-Non-Small Cell Lung Cancer
Excerpt:
...Prior adjuvant chemotherapy > 1 year ago and prior treatment with an EGFR-TKI for patients with an activating EGFR mutation is allowed....
Source:
Title:
A non-interventional, single-arm, prospective clinical study for the efficacy and safety of gefitinib combined with bevacizumab and pemetrexed in first-line treatment of stage IV EGFR mutant non-squamous non-small cell lung cancer.
Excerpt:
...EGFR mutation was positive (including 19del, L858R, g719a, g719c, G719S, l861q)....
Trial ID:
Source:
Title:
Clinical Study of EGFR-TKI Combined with Bevacizumab in Patients with Stage IIIB/IVNon-Small-Cell Lung Cancer Harboring EGFR Mutation and PD-L1 Positive
Excerpt:
...The sensitive mutation of EGFR gene (exon 19del, exon L858R) was detected. ...
Trial ID:
Source:
Title:
A Phase II trial of Acteinib combined with Bevacizumab in the treatment of brain metastases from advanced EGFR mutation-positive lung adenocarcinoma
Excerpt:
...Patients with lung adenocarcinoma confirmed by histology or cytology and detected EGFR mutation; 4. ...
Trial ID:
Source:
Title:
Bevacizumab Plus EGFR-TKIs in Chinese Patients With EGFR-mutant NSCLC: a Real-world Study
Excerpt:
...An exon 19 deletion mutation or exon 21 L858R mutation in EGFR has been found clinically, with or without EGFR T790M mutation 5....
Source:
Title:
Bevacizumab Combined With Gefitinib in the Treatment of Advanced NSCLC
Excerpt:
...According to the method of second-generation sequencing, L858R point mutation in exon 21 of EGFR gene was found in primary NSCLC with or without any other coexisting mutations....
Trial ID:
Source:
Title:
BELIEF (Bevacizumab and ErLotinib In EGFR Mut+ NSCLC)
Excerpt:
...- Centrally confirmed EGFR exon 19 deletion (del19) or exon 21 mutation (L858R)...
Trial ID:
Source:
Title:
phase II study evaluating the interest of re-introduction of pemetrexed and platinum (cisplatin or carboplatin) with maintenance by bevacizumab in non squamous non small cell lung cancer of advanced stage. Etude de phase II évaluant l'intérêt de la réintroduction du pemetrexed et du platine (cisplatine ou carboplatine) avec maintien par bevacizumab dans les Cancers BronchoPulmonaires Non à Petites Cellules (CBNPC) non épidermoïdes avancés.
Excerpt:
...Non squamous non small cell lung cancer histologically or cytologically confirmed with no EGFR mutation. ...
Trial ID:
Source:
Title:
Compare Bevacizumab in Combination With Erlotinib Versus Erlotinib Alone in NSCLC Patients Activating EGFR Mutations
Excerpt:
...An exon 19 deletion mutation or exon 21 L858R mutation has been found in high-sensitivity EGFR mutation tests by PCR using tumor tissue centrally confirmed....
Trial ID:
Source:
Title:
A Study of Tarceva vs. Avastin+Tarceva for Advanced NSCLC With EGFR m(+)
Excerpt:
...- Locally diagnosed sensitive EGFR mutation positive (Exon 19 deletion or L858R)...
Trial ID:
Source:
Title:
A Multicenter, Randomised, Double blind, Parallel, Phase III Global Study to Assess the Efficacy and Safety of BP01 (Bevacizumab) when compared to Avastin®-EU in Combination with Carboplatin and Paclitaxel during Induction phase and Bevacizumab alone during the Maintenance phase in patients with newly diagnosed or recurrent Stage IIIB/IV Non Squamous (ns) Non-Small Cell Lung Cancer (NSCLC).
Excerpt:
...Subjects with histologic or cytologic diagnosis of nsNSCLC* with negative or unknown sensitizing epidermal growth factor receptor (EGFR) mutation and documented negative or unknown anaplastic lymphoma kinase (ALK) translocation.* mixed cancer types should be classified according to the predominant cell type, if small cell elements are present, subjects must be excluded.4. ...
Trial ID:
Source:
Title:
Real World Study on Erlotinib/Gefitinib Combined With Bevacizumab in Advanced Non-aquamous Non-small Cell Lung Cancer
Excerpt:
...- EGFR mutation(19del/L858R)...
Trial ID:
Source:
Title:
Study Comparing Bevacizumab + Erlotinib vs Erlotinib Alone as First Line Treatment of Patients With EGFR Mutated Advanced Non Squamous Non Small Cell Lung Cancer
Excerpt:
...Activating epidermal growth factor receptor mutation (exon19 deletion or exon 21 L858R mutation or other activating/sensitizing mutations, such as exon 21 L861Q, exon 18 G719S, G719A and G719C, exon 20 S768I and V769L)....
Trial ID:
Source:
Title:
Paclitaxel-bevacizumab in Advanced Lung Cancer
Excerpt:
...- Patient with active mutation of EGFR must have had on line of chemotherapy with platinum and one with Tyrosine kinase inhibitor of EGFR....
Trial ID:
Source:
Title:
Clinical Study of Ametinib Combined With Bevacizumab in First-line Treatment of Advanced NSCLC With EGFR-mutations.
Excerpt:
...- Non-squamous non-small cell lung cancer (NSCLC) confirmed by pathology (including histology or cytology); ③ EGFR mutation positive (exon 19 deletion or exon 21 L858R mutation); (4) ≥3 intracranial metastases, asymptomatic brain metastases; (5) Never received antitumor therapy before;...
Trial ID:
Less C2 evidence
Source:
Title:
Comparing Different Anti-angiogenic Agents and TKI Combinations in EGFR-mutated Advanced NSCLC: a Retrospective Study
Published date:
08/08/2023
Excerpt:
In TKI treatment-naïve patients, bevacizumab exhibited a higher objective response rate (75% vs. 50%, p = 0.21) and disease control rate (94.4% vs. 50%, p = 0.007), as well as a longer median PFS (15.2 vs. 8.7 months, p < 0.001) than ramucirumab…In untreated EGFR-mutated metastatic NSCLC patients, bevacizumab plus EGFR-TKIs seemed to show better PFS...
Secondary therapy:
Tyrosine kinase inhibitor
Source:
Title:
Clinical efficacy and prognosis analysis of treatment regimens for EGFR mutant non-small cell lung cancer and brain metastasis: a retrospective study
Published date:
03/30/2023
Excerpt:
In this retrospective study, 172 EGFRm + patients with advanced NSCLC who received a 1st generation EGFR tyrosine kinase inhibitor (TKI) were divided into 4 groups: A, EGFR-TKI (n = 84); B, EGFR-TKI + pemetrexed + cisplatin/carboplatin chemotherapy (CT) (n = 55); C, EGFR-TKI + bevacizumab (n = 15); and D, EGFR-TKI + pemetrexed + cisplatin/carboplatin CT + bevacizumab (n = 18)....Significant difference was found in intracranial ORR between groups A + B vs. C + D (31.0% vs. 65.2%, P = 0.002).
Secondary therapy:
EGFR inhibitor + cisplatin + pemetrexed; EGFR inhibitor + carboplatin + pemetrexed
DOI:
https://doi.org/10.1186/s12885-023-10744-2
Source:
Title:
The different overall survival between single-agent EGFR-TKI treatment and with bevacizumab in non-small cell lung cancer patients with brain metastasis
Published date:
03/15/2022
Excerpt:
310 patients of advanced NSCLC with common EGFR mutation receiving first-generation EGFR-TKI monotherapy or with bevacizumab were included and propensity-score matched....In the propensity-score matched cohort, PFS (13.5 vs. 13.7 months; log-rank p = 0.700) was similar between the two groups. The OS (61.3 vs. 34.2 months; log-rank p = 0.010) and risk reduction of death (HR 0.42 [95% CI 0.20-0.85]; p = 0.017) were significantly improved in EGFR-TKI plus bevacizumab group....First-generation EGFR-TKI with bevacizumab improved treatment efficacy in real-world patients of NSCLC with EGFR mutation.
DOI:
10.1038/s41598-022-08449-w
Source:
Title:
Clinical and molecular feature-based nomogram model for predicting benefit from bevacizumab combined with first-generation EGFR-tyrosine kinase inhibitor (TKI) in EGFR-mutant advanced NSCLC
Published date:
10/19/2021
Excerpt:
Our study included 318 patients with EGFR-mutant locally advanced/advanced NSCLC treated with either first-generation EGFR-TKI combined with bevacizumab (A+T; n = 159) or EGFR-TKI monotherapy (T; n = 159)….The A+T group had significantly longer PFS (14.0 vs. 10.5 months; p < 0.001) and OS (37.0 vs. 26.0 months; p = 0.042) than the T group.
Secondary therapy:
EGFR inhibitor
DOI:
10.1186/s12916-021-02118-x
Source:
Title:
The efficacy and clinical survival outcome of different first-line treatments in EGFR-mutant non-small cell lung cancer with brain metastases.
Published date:
05/19/2021
Excerpt:
A total of 584 EGFRm+ advanced NSCLC patients from December 2017 to May 2020 were screened...the intracranial PFS of group C+D(with bevacizumab) was significantly longer than group A+B(11.3m (95%CI 12.2-14.8) vs 21.0m (95%CI 15.2-22.7), P = 0.007)....The mOS of groups A,B were 27.8m and 24.2m,respectively, but group C and D had not yet reached....For EGFR-mutant NSCLC with brain metastases, the first-generation EGFR-TKI plus bevacizumab can significantly improve the efficacy of intracranial lesions.
Secondary therapy:
EGFR inhibitor; Chemotherapy + EGFR inhibitor
DOI:
10.1200/JCO.2021.39.15_suppl.2028
Source:
Title:
EGFR-TKI plus bevacizumab versus EGFR-TKI monotherapy for patients with EGFR mutation-positive advanced non-small cell lung cancer-A propensity score matching analysis
Published date:
04/14/2021
Excerpt:
Patients with advanced EGFR-mutant NSCLC who received first-line EGFR-TKI in a tertiary referral center from October 1, 2013 to December 31, 2019 were retrospectively analyzed….45 patients who received first-line EGFR-TKI and bevacizumab and 89 patients who received EGFR-TKI alone were analyzed. The combination group showed improved PFS (17.0 vs. 11.0 months; hazard ratio [HR] = 0.48; p = 0.002) compared to the monotherapy group.
Secondary therapy:
EGFR inhibitor
DOI:
10.1016/j.jfma.2021.03.023
Source:
Title:
Efficacy and safety of original EGFR-TKI combined with bevacizumab in advanced lung adenocarcinoma patients harboring EGFR-mutation experiencing gradual progression after EGFR-TKI treatment: a single-arm study
Excerpt:
...a total of 35 metastatic EGFR positive NSCLC patients experienced gradual progression after EGFR-TKI treatments and received original TKI combined with bevacizumab...Median PFS1 and PFS2 were 20.5 and 8 months, respectively; DCR was 93.94%; median OS was immature.
Secondary therapy:
Tyrosine kinase inhibitor
DOI:
10.21037/atm-22-6101
