Clinical outcomes in elderly patients with advanced non-small cell lung cancer: results from ARIES, a bevacizumab observational cohort study

A J Wozniak; M P Kosty; M Jahanzeb; J R Brahmer; D R Spigel; L Leon; S Fish; E D Flick; S J Hazard; T J Lynch Jr

doi:10.1016/j.clon.2014.12.002

Clinical outcomes in elderly patients with advanced non-small cell lung cancer: results from ARIES, a bevacizumab observational cohort study

Clin Oncol (R Coll Radiol). 2015 Apr;27(4):187-96. doi: 10.1016/j.clon.2014.12.002. Epub 2015 Jan 7.

Authors

A J Wozniak¹, M P Kosty², M Jahanzeb³, J R Brahmer⁴, D R Spigel⁵, L Leon⁶, S Fish⁶, E D Flick⁶, S J Hazard⁶, T J Lynch Jr⁷

Affiliations

¹ Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA. Electronic address: wozniakt@karmanos.org.
² Scripps Clinic, La Jolla, CA, USA.
³ UM Sylvester Comprehensive Cancer Center, Miami, FL, USA.
⁴ Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA.
⁵ Sarah Cannon Research Institute, Nashville, TN, USA.
⁶ Genentech, Inc., South San Francisco, CA, USA.
⁷ Yale Cancer Center and Smilow Cancer Hospital, New Haven, CT, USA.

PMID: 25576353
DOI: 10.1016/j.clon.2014.12.002

Abstract

Aims: Retrospective analyses from first-line clinical studies in advanced non-small cell lung cancer (NSCLC) have reported conflicting results on progression-free survival (PFS) and overall survival benefits with the addition of bevacizumab to chemotherapy in elderly patients. Here we report effectiveness and safety outcomes by age subgroup for patients with NSCLC in the ARIES observational cohort study.

Materials and methods: ARIES enrolled patients with advanced non-squamous NSCLC who received first-line bevacizumab-containing treatment per physician's choice. Kaplan-Meier estimates were used to calculate medians and 95% confidence intervals for PFS and overall survival for patients aged <65, ≥65, <75 and ≥75 years.

Results: In total, 1967 patients receiving first-line treatment with bevacizumab and chemotherapy were enrolled. The median PFS and overall survival values were 6.4 (95% confidence interval = 6.0-6.8) and 14.2 (95% confidence interval = 12.7-15.2) months for patients aged <65 years, respectively, and 6.8 (95% confidence interval = 6.3-7.0) and 12.1 (95% confidence interval = 11.4-13.1) months for patients ≥65 years, respectively. For patients <75 years, the median PFS and overall survival values were 6.6 (95% confidence interval = 6.3-6.9) and 13.5 (95% confidence interval = 12.6-14.5) months, respectively, and 6.6 (95% confidence interval = 5.9-7.1) and 11.6 (95% confidence interval = 10.0-12.5) months, respectively, for patients ≥75 years. Incidence proportions of bevacizumab-associated adverse events were generally similar across all age groups.

Conclusions: Data from the ARIES study suggest that treatment with bevacizumab in combination with chemotherapy is a viable first-line treatment option for elderly bevacizumab-eligible patients with advanced non-squamous NSCLC.

Trial registration: ClinicalTrials.gov NCT00388206.

Keywords: Bevacizumab; NSCLC; chemotherapy; elderly; observational cohort study.

Publication types

Clinical Trial, Phase III
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Age Factors
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Bevacizumab / administration & dosage
Carcinoma, Non-Small-Cell Lung / drug therapy*
Cohort Studies
Disease-Free Survival
Female
Humans
Lung Neoplasms / drug therapy*
Male
Middle Aged
Prospective Studies
Retrospective Studies
Treatment Outcome

Substances

Bevacizumab

Associated data

ClinicalTrials.gov/NCT00388206