Effectiveness of bevacizumab exposure beyond disease progression in patients with non-small-cell lung cancer: Analyses of the ARIES observational cohort study

Larry Leon, Michael Kosty, Mohammad Jahanzeb, David Spigel, Antoinette J. Wozniak, Julie Brahmer, Susan Fish, E. Dawn Flick, Sebastien J. Hazard, Thomas J. Lynch

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Purpose: Bevacizumab used in combination with first-line chemotherapy confers an overall survival (OS) benefit for patients with non-squamous non-small-cell lung cancer (NSCLC). This analysis from the ARIES observational cohort study (OCS) was initiated to evaluate the effect of bevacizumab use beyond disease progression (BBP) on clinical outcomes in patients with NSCLC receiving first-line treatment with bevacizumab and chemotherapy. Methods: The ARIES OCS prospectively enrolled patients from 2006 to 2009 in the United States who had advanced non-squamous NSCLC, received bevacizumab with chemotherapy in the first-line setting, and survived progressive disease (PD). A dichotomous landmark analysis examined post-PD OS (ppOS) in patients who received BBP versus no BBP within 30days post PD. A time-dependent Cox model assessed the effect of cumulative BBP exposure on ppOS. Results: The ARIES OCS enrolled 1967 patients with first-line NSCLC; 1358 patients had first PD and were alive at the 30-day landmark (351 patients with BBP and 1007 patients with no BBP). The landmark analysis showed that BBP was associated with a lower risk of death (BBP versus No-BBP); hazard ratio [HR], 0.75; 95% confidence interval 0.65-0.86. In the cumulative exposure analysis of 1461 patients who had PD, HRs for ppOS decreased by approximately 4% for each additional 21-day interval of bevacizumab received. Protocol-specified bevacizumab-select adverse events occurred in 14% of BBP patients. Conclusions: BBP was associated with a lower risk of death in patients with NSCLC treated with first-line bevacizumab and chemotherapy.

Original languageEnglish (US)
Pages (from-to)569-577
Number of pages9
JournalPharmacoepidemiology and Drug Safety
Volume25
Issue number5
DOIs
StatePublished - May 1 2016

Keywords

  • Bevacizumab
  • Non-small-cell lung cancer
  • Observational cohort study
  • Pharmacoepidemiology
  • Treatment beyond progression

ASJC Scopus subject areas

  • Epidemiology
  • Pharmacology (medical)

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