Long-term Progression-free Survival With Pemetrexed Plus Bevacizumab in NSCLC Patients.

Abstract

Pemetrexed (PEM) and bevacizumab (BEV) are commonly used in combination as second or subsequent line regimens and maintenance therapy after platinum + PEM + BEV therapy for advanced non-small cell lung cancer (NSCLC). Median progression-free survival (PFS) for PEM + BEV has been reported to be less than six months in both clinical trials and clinical practice, but in clinical practice, we found that some patients demonstrate long-term PFS. Furthermore, there is a paucity of clinical practice data on whether long-term administration of PEM + BEV causes renal dysfunction. This study aimed to clarify these aspects in clinical practice. A retrospective review of patients with advanced NSCLC treated with PEM + BEV between September 2011 and June 2022 at four hospitals was conducted. Long-term PFS in PEM + BEV therapy was defined as ≥12 months. During the study period, 109 patients received PEM + BEV treatment. Of them, 42 (38.5%) achieved long-term PFS ≥12 months. No significant differences in patient characteristics were found between patients with PFS ≥12 months and <12 months, except for 'relapse after resection'. Univariate and multivariate analysis showed that the favorable factor for PFS was 'relapse after resection'. With regard to influence on renal function of PEM + BEV therapy, no significant difference was found before and after PEM+BEV therapy between these two groups. NSCLC patients commonly achieved long-term PFS with PEM + BEV therapy with no observed effects on renal function.