Cancer Res Treat.  2022 Apr;54(2):434-444. 10.4143/crt.2021.671.

The Clinical Outcomes of Different First-Line EGFR-TKIs Plus Bevacizumab in Advanced EGFR-Mutant Lung Adenocarcinoma

• Huang YH
• Hsu KH
• Chin CS
• Tseng JS
• Yang TY
• Chen KC
• Su KY
• Yu SL
• Chen JJ
• Chang GC

• KMID: 2528213
• DOI: http://doi.org/10.4143/crt.2021.671

Abstract

Purpose
The aim of this study was to investigate the efficacy of various epidermal growth factor receptor (EGFR)–tyrosine kinase inhibitors (TKIs) plus bevacizumab in advanced EGFR-mutant lung adenocarcinoma patients.
Materials and Methods
From August 2016 to October 2020, we enrolled advanced lung adenocarcinoma patients harboring exon 19 deletion or L858R receiving gefitinib, erlotinib and afatinib plus bevacizumab as the first-line treatment for the purposes of analysis.
Results
A total of 36 patients were included in the final analysis. Three patients received gefitinib, 17 received erlotinib, and 16 received afatinib combined with bevacizumab as the first-line treatment. The objective response rate was 77.8%, and disease control rate was 94.4%. The overall median progression-free survival (PFS) was 16.4 months, while the median PFS was 17.1 months in patients with exon 19 deletion, and 16.2 months in patients with L858R mutation (p=0.311). Regarding the use of different EGFR-TKIs, the median PFS was 17.1 months in the erlotinib group and 21.6 months in the afatinib group (p=0.617). In patients with brain metastasis at baseline, the median PFS was 18.9 months in the erlotinib group and 16.4 months in the afatinib group (p=0.747). Amongst patients harboring exon 19 deletion, the median PFS was 16.2 months in the erlotinib group and not-reached in the afatinib group (p=0.141). In patients with L858R mutation, the median PFS was 18.9 months in the erlotinib group and 16.2 months in the afatinib group (p=0.481).
Conclusion
Our research demonstrates that not only erlotinib combined with bevacizumab, but also afatinib plus bevacizumab as first-line treatment, provides solid clinical efficacy in advanced EGFR-mutant lung adenocarcinoma patients.

Keyword

ErbB receptors; Tyrosine kinase inhibitor; Bevacizumab; Lung neoplasms; Adenocarcinoma

Figure

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  Fig. 1 The flowchart of patient collection. EGFR, epidermal growth factor receptor; TKI, tyrosine kinase inhibitor; VEGF, vascular endothelial growth factor.

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  Fig. 2 Clinical efficacy of epidermal growth factor receptor–tyrosine kinase inhibitor combined with bevacizumab. (A) Progression-free survival. (B) Overall survival. (C) Progression-free survival of patients with exon 19 deletion and exon 21 L858R mutation. (D) Progression-free survival of patients with brain and without brain metastasis at baseline. CI, confidence interval.

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  Fig. 3 Progression-free survival of patients with erlotinib and afatinib as first-line treatment combined with bevacizumab. (A) Progression-free survival of different epidermal growth factor receptor–tyrosine kinase inhibitors (EGFR-TKIs) in all patients. (B) Progression-free survival of different EGFR-TKIs in patients with brain metastasis at baseline. (C) Progression-free survival of different EGFR-TKIs in patients harboring exon 19 deletion. (D) Progression-free survival of different EGFR-TKIs in patients harboring exon 21 L858R point mutation. CI, confidence interval.

Reference

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