Comparison of carboplatin and paclitaxel with or without bevacizumab in chemotherapeutic regimens for unresectable stage III non-small cell lung cancer

OBJECTIVE: Our study aimed to compare the chemoradiotherapeutic regimens of carboplatin and paclitaxel with or without bevacizumab for stage III non-small cell lung cancer (NSCLC).

PATIENTS AND METHODS: From July 2010 to December 2016, 102 patients with inoperable stage III NSCLC were finally included and divided randomly into two groups. Patients in the CP group received the treatment of carboplatin (area under the curve of 6) on day 1 and paclitaxel (80 mg/m2) on days 1, 8, and 15. Patients in the CPB group received the treatment of carboplatin (area under the curve of 6) on day 1, paclitaxel (80 mg/m2) on days 1, 8, and 15 plus bevacizumab (15 mg/kg) on day 1. The two chemotherapy regimens were repeated every 4 weeks. Patients were treated for about 4-6 cycles until the occurrence of toxicity or patient refusal, or progressive disease.

RESULTS: The median overall survival (OS) and progression-free survival (PFS) in the CPB treated group were significantly higher than that in the CP treated group (OS: p<0.01; PFS: p<0.01; respectively). The rates of response and disease control were higher in the CPB treated group (77%, 98%, respectively) compared to the CP treated group (59%, 94%, respectively), although there was no statistical significance. Regarding the toxicities of chemotherapy, we found higher rates of leukopenia and neutropenia in the CPB group, while frequent occurrence of esophagitis, eruption and thrombocytopenia in the CP group.

CONCLUSIONS: The carboplatin plus paclitaxel plus bevacizumab regimen was more effective and well tolerated in patients with unresectable stage III NSCLC compared with the carboplatin plus paclitaxel regimen. The CPB regimen may be a better alternative to the current standard regimen.

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