Adding Carboplatin to Pemetrexed and Bevacizumab Effective as First-Line Therapy for Elderly Patients with Lung Cancer

CHICAGO―Adding carboplatin to first-line combination pemetrexed and bevacizumab therapy exhibits efficacy among elderly patients diagnosed with nonsquamous non-small cell lung cancer (NSCLC), report authors of a randomized open-label, phase 3 clinical trial in Germany, presented at the 2013 American Society of Clinical Oncology (ASCO) Annual Meeting.

The combination demonstrates “strong efficacy with acceptable toxicity” among elderly patients diagnosed with NSCLC, reported Wolfgang Schuette, MD, of the Hospital Martha-Maria Halle-Doelau in Halle, Germany, and coauthors.

“Addition of carboplatin (C) is recommended for eligible patients,” Dr. Schuette and coauthors reported. “However, in patients with ECOG PS-2, the administration of C must be carefully reviewed.”

A total of 251 elderly participants were randomly assigned to receive pemetrexed plus bevacizumab (P 500 mg/m2 + B 7.5 mg/kg either with (n=118) or without (n=133) carboplatin (P+B+C area under the curve 5, day 1 every 3 weeks for four to six cycles).

The overall response rate (ORR) was superior among patients receiving carboplatin (31.4% vs. 44.4%; P=0.0343), they reported.

Grade 3+ adverse event profiles were “comparable” between treatment groups, the authors noted: grade 3/4 adverse events were seen in 76 (64.4%) of patients receiving pemetrexed and bevacizumab alone versus 87 patients (65.5%) among those also receiving carboplatin. 

Among elderly patients with ECOG PS 0-1 who received carboplatin, median overall survival (OS) was 15.8 months, which was not statistically significantly different from a median 12-month OS among patients not receiving carboplatin, the coauthors noted.