OBJECTIVES:Bevacizumab has been approved by the US Food and Drug Administration as a first-line therapy for metastatic non-small-cell lung cancer (NSCLC), in combination with carboplatin and paclitaxel. A single Latin American center experience was reviewed to determine the safety and efficacy of adding bevacizumab to first-line chemotherapy in a local population. METHODS:We retrospectively identified patients with non-squamous NSCLC treated with bevacizumab plus chemotherapy combinations as first-line chemotherapy between July 1, 2006, and January 30, 2011, at Sirio Libanes Hospital in Sao Paulo, Brazil. We collected data on patient characteristics, treatment combinations, toxicities, response to treatment, and survival. Overall survival (OS) and progression-free survival (PFS) were calculated by Kaplan-Meier analysis, and prognostic factors were identified by the Cox regression model. RESULTS:A total of 56 patients were included in the final analysis (median age 62.4 years; 70% male). In 35 patients (62.5%), bevacizumab was combined with carboplatin and paclitaxel, and in 16 patients (28.6%), it was combined with pemetrexed and carboplatin. The response rate evaluated by the reference clinical team reached 74.5%, the median PFS was 5.3 months, and the median OS was 14.8 months. In multivariate analysis, use of maintenance therapy was the only predictive factor for OS (hazard ratio 6.85, 95% confidence interval 2.94-15.22). No treatment-related deaths were identified, and the overall incidence of grade 3-4 non-hematologic toxicities was 16%. CONCLUSION:Our results confirm the efficacy and safety data of bevacizumab first-line combinations for NSCLC in a Brazilian population.

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目的:贝伐单抗已被美国食品和药物管理局批准作为转移性非小细胞肺癌(NSCLC)与卡铂和紫杉醇联合治疗的一线治疗药物。回顾了一个拉丁美洲中心的经验,以确定在当地人群中将贝伐单抗添加到一线化疗中的安全性和有效性。
方法:我们回顾性分析了2006年7月1日至2011年1月30日期间在巴西圣保罗的Sirio Libanes医院接受贝伐单抗联合化疗联合治疗的非鳞状非小细胞肺癌的患者作为一线化疗的方法。我们收集了有关患者特征,治疗组合,毒性,治疗反应和生存率的数据。通过Kaplan-Meier分析计算总生存期(OS)和无进展生存期(PFS),并通过Cox回归模型确定预后因素。
结果:最终分析共纳入56例患者(中位年龄62.4岁;男性占70%)。贝伐珠单抗联合卡铂和紫杉醇治疗35例患者(占62.5%),培美曲塞和卡铂联合治疗16例患者(占28.6%)。参考临床团队评估的缓解率为74.5%,中位PFS为5.3个月,中位OS​​为14.8个月。在多因素分析中,维持治疗是OS的唯一预测因素(危险比6.85,95%置信区间2.94-15.22)。没有发现与治疗相关的死亡,并且3-4级非血液学毒性的总发生率为16%。
结论:我们的结果证实了贝伐单抗一线联合治疗NSCLC在巴西人群中的疗效和安全性数据。

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