Nav: Home

Drug combination may provide option to patients with NSCLC ineligible for bevacizumab

April 03, 2012

CHICAGO -- A combination of nab-paclitaxel and carboplatin for the treatment of non-small cell lung cancer may be a promising option for patients ineligible for treatment with bevacizumab, according to data presented at the AACR Annual Meeting 2012, held here March 31 - April 4.

"The combination of carboplatin and nab-paclitaxel demonstrates promising efficacy with tolerable toxicity in patients with non-small cell lung cancer (NSCLC) ineligible for therapy with bevacizumab," said Gregory A. Otterson, M.D., professor of internal medicine, co-director of the thoracic oncology program and associate director of the hematology and medical oncology fellowship program at The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute in Columbus, Ohio.

Otterson and colleagues evaluated the drug combination in 63 patients with advanced NSCLC. Seventy-six percent of patients had squamous histology, making them ineligible for bevacizumab. Other contraindications for bevacizumab among this patient population included hemoptysis, thrombosis and therapeutic anticoagulation. Researchers assigned patients to 300 mg/m2/AUC6, which was later adjusted to 260 mg/m2/AUC6 due to excess neuropathy, every 21 days.

Researchers found an overall response rate of 41 percent among 53 patients available for evaluation. An additional 39 percent of patients had stable disease for at least six weeks. Disease progressed in 19 percent of patients.

"We have been surprised at the durability of response with some patients not requiring further treatment for at least six months," Otterson said.

More than 10 percent of patients had grade 3 to 4 toxicities, including hematologic toxicity, febrile neutropenia, infection, sensory neuropathy, dyspnea and dehydration; researchers reported four deaths as grade 5 toxicities. "This combination treatment should be an option, particularly for patients with squamous histology who have limited alternative options," Otterson said.
Press registration for the AACR Annual Meeting 2012 is free to qualified journalists and public information officers:

Follow the AACR on Twitter: @aacr #aacr

Follow the AACR on Facebook:

About the AACR

Founded in 1907, the American Association for Cancer Research (AACR) is the world's first and largest professional organization dedicated to advancing cancer research and its mission to prevent and cure cancer. AACR's membership includes 34,000 laboratory, translational and clinical researchers; population scientists; other health care professionals; and cancer advocates residing in more than 90 countries. The AACR marshals the full spectrum of expertise of the cancer community to accelerate progress in the prevention, biology, diagnosis and treatment of cancer by annually convening more than 20 conferences and educational workshops, the largest of which is the AACR Annual Meeting with more than 18,000 attendees. In addition, the AACR publishes seven peer-reviewed scientific journals and a magazine for cancer survivors, patients and their caregivers. The AACR funds meritorious research directly as well as in cooperation with numerous cancer organizations. As the Scientific Partner of Stand Up To Cancer, the AACR provides expert peer review, grants administration and scientific oversight of individual and team science grants in cancer research that have the potential for patient benefit. The AACR actively communicates with legislators and policy makers about the value of cancer research and related biomedical science in saving lives from cancer.

For more information about the AACR, visit

Presenter: Gregory A. Otterson, M.D.

Abstract Number: LB-225

Title: Phase 2 Trial of nab-paclitaxel plus carboplatin for advanced NSCLC in patients at risk of bleeding from VEGF directed therapies

Author Block: Erin M. Bertino, Miguel A. Villalona-Calero, Patrick Nana-Sinkam, Sarah Cantrel, Meliha Rahmani, Carrie Symmes, Gary S. Phillips, Gregory A. Otterson. Ohio State Univ. Comp. Cancer Ctr., Columbus, OH

Background: The addition of bevacizumab (Bev) to platinum based chemotherapy results in higher response rate (RR), progression-free survival (PFS), and overall survival (OS) in advanced non-small cell lung cancer (NSCLC). However, Bev is not indicated in patients (pts) with squamous histology or with hemoptysis due to bleeding risk,. Nab-paclitaxel is a novel formulation of paclitaxel with higher dose tolerance and potentially improved efficacy. A previous study of nab-paclitaxel/Carboplatin (using an alternative schedule) showed a higher response rate in patients with squamous histology (Socinski, et al, ASCO 2010, LBA7511). We hypothesized that in pts with NSCLC ineligible for Bev therapy the combination of nab-paclitaxel and carboplatin (Cb) would be superior to alternative doublets.

Methods: We conducted a single-arm, single-institution phase 2 trial (NCT00729612) to evaluate RR (primary endpoint), safety/toxicity, and survival (OS, PFS - secondary endpoints) in patients treated with nab-paclitaxel and carboplatin (Cb). Eligible pts included: squamous histology, history of hemoptysis, requirement for anticoagulation. Correlative studies included blood microRNA profiles pre-treatment. Treatment was administered every 21 days, initially at 300 mg/m2/AUC=6, but then adjusted to 260 mg/m2/AUC6 due to excess neuropathy.

Results: 63 pts (21 female, 42 male) with median age 63 yrs (range 36-82) were enrolled. Pts had an average 50 pk-yrs tobacco use. The most common histology was squamous cell carcinoma (48 pts/76%), followed by adenocarcinoma (9 pts/14%), NSCLC NOS (4 pts/6%) and adenosquamous (2 pts/3%). In non-squamous pts, eligibility criteria included hemoptysis (11 pts), thrombosis (2 pts), and therapeutic anticoagulation (1 pt). Grade 3-4 toxicities seen in more than 10% of pts included hematologic toxicity (36 pts/57%), febrile neutropenia (9/14%), infection (15/24%), sensory neuropathy (17/27%), dyspnea (10/16%) and dehydration (8/13%). Four deaths_including 1 sudden death and 1 death due to respiratory failure_were reported on study as grade 5 toxicity. ORR was 41% (22 PR/0 CR) in the 53 pts evaluable to date with 39% (21 pts) stable disease and 19% (10 pts) progressive disease. PFS/OS data is not yet available.

Conclusions: The combination of Cb and nab-paclitaxel demonstrates promising efficacy with tolerable toxicity in NSCLC pts ineligible for Bev therapy. Further study in the squamous cell population is warranted. Correlative studies of microRNA profiles and survival data (OS and PFS) is maturing and will be available in the near future.

American Association for Cancer Research

Related Bevacizumab Articles:

PET/CT helps predict therapy effectiveness in pediatric brain tumors
In this first ever molecular drug-imaging study in children, researchers in The Netherlands used whole-body positron emission tomography/computed tomography (PET/CT) scans to determine whether bevacizumab (Avastin) treatment of diffuse intrinsic pontine glioma (DIPG) in children is likely to be effective.
Immunologic changes point to potential for clinical investigation of combination immunotherapy for deadly kidney cancer
Immunologic changes observed in an early study of patients with metastatic renal cell carcinoma (MRCC) raised the possibility for a larger clinical study of combination immunotherapy, according to findings reported by researchers at The University of Texas MD Anderson Cancer Center.
Repeated eye injections for age-related macular degeneration associated with increased risk for glaucoma
Patients with age-related macular degeneration who received seven or more eye injections of the drug bevacizumab annually had a higher risk of having glaucoma surgery, according to a study published online by JAMA Ophthalmology.
Nasal sprays not effective in reducing duration, frequency of nosebleeds caused by blood vessel disorder
Two studies appearing in the Sept. 6 issue of JAMA examine the effectiveness of nasal sprays to reduce the frequency and duration of nosebleeds caused by hereditary hemorrhagic telangiectasia (HHT), an inherited condition characterized by abnormal blood vessels which are delicate and prone to bleeding.
High-priced drugs used to treat diabetic macular edema not cost-effective
The anti-vascular endothelial growth factor drugs ranibizumab and aflibercept, used to treat vision loss from diabetic macular edema (DME), and approximately 20 to 30 times more expensive than bevacizumab, are not cost-effective for treatment of DME compared to bevacizumab unless their prices decrease substantially, according to a study published online by JAMA Ophthalmology.
Moffitt: Radiation therapy with pembrolizumab, bevacizumab safe for glioma patients
Moffitt Cancer Center will present preliminary results from a phase 1 study testing whether the addition of pembrolizumab to radiation therapy and bevacizumab is safe and can control tumor growth for these patients.
Anticancer drug restores hearing in some patients with neurofibromatosis
In a small clinical study with an anticancer drug that halts blood vessel growth, a handful of people with neurofibromatosis type 2 (NF2) and hearing loss had restoration of hearing.
St. Joseph's Hospital research reveals standard treatment for ovarian cancer
Research led by a Dignity Health St. Joseph's Hospital and Medical Center physician on ovarian cancer was published in the Feb.
Combination of bevacizumab and lomustine with first recurrence of glioblastoma prolongs PFS but not OS
Results of EORTC trial 26101 presented today at the 20th Annual Scientific Meeting and Education Day of the Society for Neuro-Oncology showed that bevacizumab treatment in patients with progressive glioblastoma, despite prolonged progression-free survival, does not confer a survival advantage.
Antiangiogenic breast cancer treatment may benefit only patients with well-perfused tumors
A Massachusetts General Hospital research team, in collaboration with at Dana-Farber Cancer Institute investigators, may have found a reason why the use of antiangiogenesis drugs -- which has improved outcomes for patients with several types of cancer -- fails to benefit some breast cancer patients.

Related Bevacizumab Reading:

Bevacizumab: Webster's Timeline History, 2001 - 2007
by Icon Group International (Author)

Webster's bibliographic and event-based timelines are comprehensive in scope, covering virtually all topics, geographic locations and people. They do so from a linguistic point of view, and in the case of this book, the focus is on "Bevacizumab," including when used in literature (e.g. all authors that might have Bevacizumab in their name). As such, this book represents the largest compilation of timeline events associated with Bevacizumab when it is used in proper noun form. Webster's timelines cover bibliographic citations, patented inventions, as well as non-conventional and alternative... View Details

AVASTIN (Bevacizumab): Treats Cancer, including Colorectal, Lung, Glioblastoma, Kidney, Cervical, and Ovarian Cancer
by James Lee Anderson (Author)

“Although, your health condition may impact your everyday life, do not let it define who you are.” AVASTIN (Bevacizumab) injection is given with other medicines to treat patients with metastatic (a cancer that has spread) carcinoma of the colon or rectum. This medicine is also used to treat a certain type of metastatic lung cancer called nonsquamous, non-small cell lung cancer, and a certain type of brain tumor called glioblastoma. AVASTIN (Bevacizumab) is a substance that helps the body fight cancer. It prevents the growth of certain types of blood vessels to cancer cells. This helps to... View Details

Handbook of Neuro-Oncology Neuroimaging, Second Edition
by Herbert B. Newton (Editor)

Remarkable progress in neuro-oncology due to increased utilization of advanced imaging in clinical practice continues to accelerate in recent years. Refinements in magnetic resonance imaging (MRI) and computed tomography (CT) technology, and the addition of newer anatomical, functional, and metabolic imaging methods, such as MRS, fMRI, diffusion MRI, and DTI MRI have allowed brain tumor patients to be diagnosed much earlier and to be followed more carefully during treatment. With treatment approaches and the field of neuro-oncology neuroimaging changing rapidly, this second edition of the... View Details

Translational Advances in Gynecologic Cancers
by Michael Birrer (Editor), Lorenzo Ceppi (Editor)

Translational Advances in Gynecologic Cancers straddles the bench and bed divide by highlighting important and interesting research that is translatable to the clinic. The contents of this book cover the entire spectrum, from promising laboratory based research, to clinical trial efforts. Further, new therapeutic indications based upon randomized phase III trials are also included.

Clinicians will learn about lab-based science that is about to enter the clinic, along with the rationale behind translational endpoints in trials. Researchers will be able to identify and... View Details

Yanoff & Duker's Retina and Vitreous Access Code, 1e
by Jay S. Duker MD (Author), Myron Yanoff MD (Author), Sophie Bakri (Author)

Providing the latest diagnostic techniques, medical and surgical therapies for approaching patients with disorders of the retina and posterior segment, this ebook features the complete retina and vitreous section from Yanoff & Duker’s Ophthalmology 4th Edition, comprising 44 chapters with 13 videos. Delivering a wealth of coverage including: newest drug therapies (Anti-VEGF for wet ARMD and bevacizumab for complications of diabetes); expanded uses of optical coherence tomography (OCT) and ancillary imaging; dystrophies; vascular and macular disorders; surgery principles; retinal... View Details

Molecular Approach to Cancer Management
by Gajanan V. Sherbet (Author)

Molecular Approach to Cancer Management discusses molecular mechanisms of cancer initiation, growth and secondary spread, emphasizing how this information can be used to devise new modes of treatment of cancer, especially in combatting secondary spread. The book addresses the basic concepts relating to cancer biology, the genetic determinants, and the signal transduction cascades associated with tumor growth, EMT, stem cell maintenance and propagation, and invasion and metastasis. The salient features of the signaling systems that are amenable to targeted manipulation are emphasized... View Details

A pilot study to determine the timing and effect of bevacizumab on vascular normalization of metastatic brain tumors in breast cancer
by Calamba City Press (Author)

To determine the appropriate time of concomitant chemotherapy administration after antiangiogenic treatment, we investigated the timing and effect of bevacizumab administration on vascular normalization of metastatic brain tumors in breast cancer patients. Proceeds from the sale of this book go to support an elderly disabled person. View Details

Efficacy and safety of bevacizumab plus chemotherapy compared to chemotherapy alone in previously untreated advanced or metastatic colorectal cancer: a systematic review and meta-analysis
by Abadan Press (Author)

Colorectal cancer (CRC) is the fourth most frequently diagnosed cancer and the second leading cause of neoplasm-related death in the United States. Several studies analyzed the efficacy of bevacizumab combined with different chemotherapy regimens consisting on drugs such as 5-FU, capecitabine, irinotecan and oxaliplatin. This systematic review aims to evaluate the effectiveness and safety of chemotherapy plus bevacizumab versus chemotherapy alone in patients with previously untreated advanced or metastatic colorectal cancer (mCRC). Proceeds from the sale of this book go to support an elderly... View Details

Rupture of abdominal aortic aneurysm after intravitreal bevacizumab injection: a case report
by Dudley Press (Author)

We describe the case of a man who died of an abdominal aortic aneurysm rupture after an intravitreal injection of bevacizumab for neovascular age-related macular degeneration. Proceeds from the sale of this book go to support an elderly disabled person. View Details

All About Bevacizumab
by Aneta Zygulska (Author), Krzysztof Krzemieniecki (Author)

Remission during sunitinib (a multikinase inhibitor and antiangiogenic drug) treatment correlates with appearance of macrocytosis. There are some suggestions that bevacizumab, an antiangiogenic drug, may result in macrocytosis as well. No available published data on the influence of bevacizumab on macrocytosis has been so far. This paper attempts to answer the question: does bevacizumab induce macrocytosis being a predictor of the response? Moreover, treatment of solid tumors and non-cancerous diseases is discussed in the second part of this paper. View Details

Best Science Podcasts 2017

We have hand picked the best science podcasts for 2017. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Simple Solutions
Sometimes, the best solutions to complex problems are simple. But simple doesn't always mean easy. This hour, TED speakers describe the innovation and hard work that goes into achieving simplicity. Guests include designer Mileha Soneji, chef Sam Kass, sleep researcher Wendy Troxel, public health advocate Myriam Sidibe, and engineer Amos Winter.
Now Playing: Science for the People

#448 Pavlov (Rebroadcast)
This week, we're learning about the life and work of a groundbreaking physiologist whose work on learning and instinct is familiar worldwide, and almost universally misunderstood. We'll spend the hour with Daniel Todes, Ph.D, Professor of History of Medicine at The Johns Hopkins University, discussing his book "Ivan Pavlov: A Russian Life in Science."