Paclitaxel-Carboplatin versus Bevacizumab Paclitaxel-Carboplatin for Treatment of Non-Small-Cell Lung Cancer

Background: Lung cancer is considered as the leading cause attributed to cancer related deaths and approximately 85% of lung cancer patients have non-small-cell lung cancer (NSCLC) and Vascular endothelial growth factor (VEGF) is used to play the major role in regulation of angiogenesis in malignancies. Aim: The aim of this study was to compare chemotherapy alone in comparison with addition of anti -vegf (bevacizumab) to chemotherapy and assessment of response rate , progression free survival, overall survival in patients diagnosed with nonsquamous non small cell lung cancer in Saudi German hospitals in the period between March 2013 and February 2016. Patients and methods: This study was held between March 2013 and February 2016 in Saudi German hospitals when we performed a randomized study in which 40 patients with recurrent or advanced nonsmall-cell lung cancer (stage IIIB or IV) received paclitaxel and carboplatin (paclitaxel-carboplatin arm) (20 patients) paclitaxel and carboplatin in addition to bevacizumab (paclitaxel-carboplatin-bevacizumab arm) (20 patients). Results: The median overall survival was 15.5 months in the paclitaxel-carboplatin-bevacizumab arm as compared with 10.5 months in the paclitaxelcarboplatin arm ( P=0.002) and the median progression-free survival was also significantly improved in the paclitaxel-carboplatin-bevacizumab arm reaching (8.4 months versus 5.9 in the paclitaxel-carboplatin arm) for a hazard ratio for disease progression of 0.67 (95% CI, 0.57 to 0.77; P<0.001) and the addition of bevacizumab to paclitaxel and carboplatin improved the response rate as (25 %) in the paclitaxel-carboplatin arm had a response versus (65%) in the paclitaxel-carboplatin-bevacizumab arm (P<0.001) and the rates of hypertension, bleeding, thrombocytopenia, neutropenia, febrile neutropenia, proteinuria were significantly higher in the paclitaxel-carboplatin-bevacizumab arm than in the paclitaxel-carboplatin arm. (P<0.05). Conclusion: The addition of bevacizumab to the chemotherapy added a significant value to the patients with non squamous NSCLC in terms of response rate, progression free survival and overall survival however with significant side effects.