Journal
ONCOLOGY AND THERAPY
Volume 9, Issue 2, Pages 489-503Publisher
SPRINGER
DOI: 10.1007/s40487-021-00152-6
Keywords
Antiangiogenesis; Bevacizumab; Epidermal growth factor receptor mutation; Erlotinib; Lung adenocarcinoma; Tyrosine kinase inhibitor; T790M
Categories
Funding
- Taiwan Ministry of Science and Technology (MOST) [109-2628-B-182A-009]
- Chang-Gung Medical Research Project [CMRPG3K1561, CMRPG8E1661-3, CMRPG8F1441, CMRPG8F1351, CMRPG8H1201, CORPG8F1491-3]
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This study analyzed the clinical features of 49 patients with metastatic EGFR-mutated lung adenocarcinoma receiving first-line therapy based on erlotinib combined with bevacizumab. The combination therapy showed high objective response rates and disease control rates, with no impact on secondary EGFR-T790M mutations in patients with acquired resistance.
Introduction: The clinical features of patients with metastatic epidermal growth factor receptor (EGFR)-mutated lung adenocarcinoma receiving first-line therapy based on erlotinib combined with bevacizumab are unclear. Here, we sought to analyze the clinical features of this patient group. Methods: Data were analyzed for the period from January 2015 to August 2019 for 49 patients with metastatic EGFR-mutated lung adenocarcinoma receiving first-line erlotinib-and-bevacizumab combination therapy from the Linkou and Kaohsiung Chang Gung Memorial Hospitals. Results: The combination of erlotinib and bevacizumab showed an 83.7% objective response rate and a 97.9% disease control rate. The median progression-free survival (PFS) and overall survival (OS) were 22.0 [95% CI (19.7-22.33)] and 47.6 [95% CI (38.87-56.37)] months, respectively, for all patients. The secondary EGFR-T790M mutation rate in the patients with acquired resistance to the combination was 72.4%. No predictive factor associated with the appearance of secondary EGFR-T790M mutations was found. The most frequent adverse event (AE) caused by the combination therapy was dermatitis (100%), and most of the AEs were manageable and grades 1 and 2. Conclusion: Erlotinib combined with bevacizumab is an effective and safe therapy for untreated metastatic EGFR-mutated lung adenocarcinoma. The combination does not alter secondary EGFR-T790M mutations in patients with acquired resistance and is feasible in real-world clinical practice. Graphic
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