Bevacizumab (Avastin) in Combination with Platinum-Based Chemotherapy as First-Line Therapy for Advanced Non-Small Cell Lung Cancer in Different Age Groups in Germany

Introduction: The non-interventional study AVAdeno (ML28306, NCT01827852) investigated the therapy with bevacizumab (Avastin^®) in combination with platinum-based chemotherapy in daily clinical practice in Germany as a treatment for advanced non-squamous Non-Small Cell Lung Cancer (NSCLC). The study had a particular focus on age-related differences.

Methods: The study analyzed 1015 patients treated with bevacizumab according to the EU label between 2013 and 2017 at 135 sites.

Objectives included treatment effectiveness and safety in the four predefined age groups (< 60, 60 – 69, 70 – 79, and ≥ 80 years), therapeutic decision details, bevacizumab application, and therapy evaluation by the treating investigators.

Results: Patient characteristics were fairly balanced in the four age groups at baseline with considerably fewer patients in the age group ≥ 80 years.

The median dose of bevacizumab during the first 15 cycles was 7.5 mg/kg across all age groups. Younger age groups were associated with higher cumulative doses of bevacizumab.

Therapeutic decisions were predominantly tumor board decisions and followed guidelines in all age groups.

Patients up to 79 years of age had a similar therapy benefit with regard to median PFS [99% CI] (age < 60: 6.28 months [5.32, 7.13], 60 – 69: 6.34 months [5.52, 7.39], 70 – 79: 6.90 months [5.72, 7.85]) and median OS [99% CI] (age < 60 years: 12.90 months [9.95, 15.50], 60 – 69: 12.50 months [10.40, 14.60], 70 – 79: 11.70 months [9.95, 14.50]). For patients ≥ 80 years, the median PFS [99% CI] (4.60 months [1.22, 9.36]) and median OS [99% CI] (10.30 months [3.61, 15.50]) were lower.

The study revealed no new toxicities or safety signals. The frequency of bevacizumab-related Adverse Events (AEs) and of Adverse Events of Special Interest (AESIs) were similar across age groups.

Disease progression was the most frequent cause of treatment discontinuation in all age groups. Patient compliance, tolerability and effectiveness of the therapy were rated good to very good by treating physicians.

Conclusions: These results confirm that guideline-orientated treatment with bevacizumab plus platinum-based chemotherapy followed by bevacizumab maintenance is a suitable treatment option for patients with advanced non-squamous NSCLC, irrespective of age.