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2017-04-07T05:21:36Z

Page créée avec « 7 However, current chemotherapy regimens, while moderately improving overall survival (OS), have reached a plateau in their effectiveness9 and also cause serious adverse e... »

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7 However, current chemotherapy regimens, while moderately improving overall survival (OS), have reached a plateau in their effectiveness9 and also cause serious adverse effects (AE) such as vomiting, renal toxicity and cytopenia.10 Significant developments have occurred over the past decade in NSCLC treatment; specifically, newer therapies directed at the molecular signaling mechanisms that promote NSCLC progression are now available and offer added clinical benefit.11,12 Vascular endothelial growth [http://www.selleckchem.com/products/dabrafenib-gsk2118436.html Dabrafenib price] factor (VEGF) helps control angiogenesis in both normal and malignant tissue.13 Bevacizumab is a humanized, murine monoclonal antibody with high specificity and affinity for VEGF-A that blocks binding of the growth factor to its receptor.14 The medication is effective against a variety of malignancies, including metastatic colon cancer15 and was the first targeted agent to improve outcomes when added to standard chemotherapy in advanced NSCLC. Bevacizumab has demonstrated efficacy as a first-line treatment for non-squamous NSCLC in two [http://www.selleckchem.com/products/sch772984.html Selleckchem SCH772984] randomized phase III studies. In the Eastern Cooperative Oncology Group 4599 trial, bevacizumab every 3?weeks plus carboplatin-paclitaxel improved OS and progression-free survival (PFS) compared with carboplatin-paclitaxel alone in 878 patients with recurrent or advanced non-squamous NSCLC and with no brain metastases.16 The hazard ratio (HR) for OS was 0.79 (P?=?0.003) and for PFS it was 0.66 (P?[http://en.wikipedia.org/wiki/Ritonavir Ritonavir] had a median OS of 10.3?months for paclitaxel-carboplatin alone and 14.2?months for paclitaxel-carboplatin and bevacizumab.17 The Avastin in Lung (AVAiL, BO17704) trial was a randomized, placebo-controlled phase III study that assessed the efficacy and safety of bevacizumab 7.5?mg/kg and 15?mg/kg every 3?weeks plus cisplatin-gemcitabine (CG) for treatment of advanced non-squamous NSCLC.18 Demographic and baseline characteristics of the intent-to-treat (ITT) patient population were well balanced across treatment groups. PFS, the primary end-point of the study, was prolonged with bevacizumab-based treatment compared with placebo.18 The HR was 0.75 for the 7.5-mg/kg bevacizumab group (95% confidence interval [CI] 0.62�C0.91, P?=?0.003) and 0.82 and 15-mg/kg group (95% CI 0.68�C0.98, P?=?0.03). Median PFS was 6.7?months for the 7.5-mg/kg bevacizumab group and 6.5?months for the 15-mg/kg group (vs 6.1?months for placebo). Objective response rates were 37.8% for the 7.5-mg/kg group and 34.6% for the 15-mg/kg group (vs 21.6% for placebo; P?��?0.0001 and P?=?0.0002, respectively).

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Notekey15 : Page créée avec « 7 However, current chemotherapy regimens, while moderately improving overall survival (OS), have reached a plateau in their effectiveness9 and also cause serious adverse e... »