Bevacizumab for the treatment of nonsquamous non-small-cell lung cancer in Portugal: a retrospective, multicenter study

Fernanda Estevinho¹, Marta Soares², Isabel Azevedo², Henrique Queiroga³, Bárbara Parente⁴, Ulisses Brito⁵, Encarnação Teixeira⁶, Renato Sotto-Mayor⁷, António Araújo<sup>8

1</sup>Medical Oncology Resident, Department of Medical Oncology, Portuguese Institute of Oncology, Oporto Center, Oporto, Portugal; ²Medical Oncology Assistant, Department of Medical Oncology, Portuguese Institute of Oncology, Oporto Center, Oporto, Portugal; ³Coordinator of the Oncological Pneumology Consultation, Pneumology Departament of Hospital S João, Oporto, Portugal; ⁴Director of Pneumology Department, Pneumology Department, Vila Nova de Gaia-Espinho Medical Center, Vila Nova de Gaia, Portugal; ⁵Director of Pneumology Department, Pneumology Department, Faro Hospital, Faro, Portugal; ⁶Pneumology assistant, Pneumology Department I, Hospital Santa Maria – Lisbon North Hospital Center, Lisbon, Portugal; ⁷Head of Service of Pneumology, Pneumology Department I, Hospital Santa Maria – Lisbon North Hospital Center, Lisbon, Portugal; ⁸Coordinator of Lung Pathology Clinic, Department of Medical Oncology, Portuguese Institute of Oncology, Oporto Center, Oporto, Portugal

Introduction: Lung cancer is the leading cause of cancer-related mortality. In patients with nonsquamous non-small-cell lung cancer (NSCLC) stage IIIB/IV treatment with chemotherapy plus bevacizumab led to significant improvements in progression-free and median overall survival (OS).
Aim: To report the experience of five Portuguese centers in treating patients with nonsquamous NSCLC in stage IIIB or IV with bevacizumab and chemotherapy regarding survival and toxicity outcomes.
Materials and methods: This was a retrospective, multicenter study on patients with nonsquamous stage IIIB/IV NSCLC treated with bevacizumab and chemotherapy from November 2007 to August 2010 through special use permits. We reviewed the medical records, registry of demographic characteristics, treatments provided, treatment responses, adverse events, and dates of death. Statistical analysis was performed with SPSS statistics software. Median OS and event-free survival (EFS) were calculated using the Kaplan–Meier method.
Results: From an eligible population of 41 patients, 37 participants were registered. Study participants were predominantly male (78.4%) with a median age of 53 years (29–75 years). In total, 83.8% patients had stage IV disease (TNM, 6th Ed.). The OS was 21.5 months (95% confidence interval [CI]: 12.6–30.5] and median EFS was 9.4 months (95% CI9: 7.1–11.7). Hematologic toxicity grade 3/4 occurred in 35.1% of patients, and nonhematologic toxicity in 24.3% patients. One fatal thromboembolic event was recorded (2.7%).
Conclusions: The results of chemotherapy plus bevacizumab treatment for nonsquamous NSCLC obtained from the daily clinical practice of the centers involved in this study were similar to those of published clinical trials. Collaboration between the different Portuguese centers is crucial for this kind of study.

Keywords: lung neoplasms, carcinoma, non-small-cell lung, nonsquamous, bevacizumab, angiogenesis inhibitors