Comparative effectiveness of adjunctive bevacizumab for advanced lung cancer: The cancer research network experience

Debra P. Ritzwoller, Nikki M. Carroll, Thomas Delate, Mark C. Hornbrook, Lawrence Kushi, Erin J Aiello Bowles, Elizabeth T. Loggers, Alex Menter

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

INTRODUCTION:: Bevacizumab plus carboplatin-paclitaxel (BCP) chemotherapy has Food and Drug Administration approval for advanced nonsquamous, non-small-cell lung cancer based upon improved survival in a clinical trial. However, subgroup analyses of this and other studies have suggested variable results by age and gender. METHODS:: Using data from four health maintenance organizations (HMOs) belonging to the Cancer Research Network, 1605 HMO nonsquamous, non-small-cell lung cancer patients aged younger than 21 years, diagnosed 2002-2010, who received carboplatin-paclitaxel (CP), with and without bevacizumab for first-line treatment of stage IIIB/IV disease were identified. Patients were categorized into three groups based on year of diagnosis and regimen during 120 days postdiagnosis: (1) diagnosed 2005-2010 and received BCP; (2) 2005-2010, CP (CP2005), and (3) 2002-2004, CP (CP2002). Survival differences between groups were estimated using Cox proportional hazard models with several propensity score adjustments for demographic, comorbidity, and tumor characteristics. Multivariable subanalyses were also estimated. RESULTS:: Median survival was 12.3 months (interquartile range [IQR], 6.0-29.1) for BCP patients versus 8.8 months (IQR, 3.7-21.3) for CP2005 patients and 7.5 months (IQR, 3.8-15.6) for CP2002 patients. In the propensity score-adjusted models, BCP demonstrated a significant survival benefit with a hazard ratio of BCP relative to CP2005 and CP2002 patients of 0.79 (95% confidence interval [CI], 0.66-0.94) and 0.63 (95% CI, 0.52-0.75), respectively. In the multivariable-adjusted subanalyses, relative to the CP2005 cohort, the BCP hazard ratios for patients age less than 65 years, age 65 years old or older, and females were 0.78 (95% CI, 0.62-1.00), 0.74 (95% CI, 0.54-1.00), and 0.77 (95% CI, 0.58-1.00). CONCLUSIONS:: In this community-based, comparative effectiveness analysis, we found an overall survival benefit for adults receiving BCP compared with CP.

Original languageEnglish (US)
Pages (from-to)692-701
Number of pages10
JournalJournal of Thoracic Oncology
Volume9
Issue number5
DOIs
StatePublished - 2014
Externally publishedYes

Keywords

  • Chemotherapy
  • Comparative effectiveness
  • Non-small cell
  • Nonsquamous
  • Overall survival

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Medicine(all)

Fingerprint Dive into the research topics of 'Comparative effectiveness of adjunctive bevacizumab for advanced lung cancer: The cancer research network experience'. Together they form a unique fingerprint.

  • Cite this

    Ritzwoller, D. P., Carroll, N. M., Delate, T., Hornbrook, M. C., Kushi, L., Bowles, E. J. A., Loggers, E. T., & Menter, A. (2014). Comparative effectiveness of adjunctive bevacizumab for advanced lung cancer: The cancer research network experience. Journal of Thoracic Oncology, 9(5), 692-701. https://doi.org/10.1097/JTO.0000000000000127