Own experience of use of EGFR tyrosine kinase inhibitors and bevacizumab in the treatment of patients with non-small cell lung cancer


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Abstract

The article presents the results of evaluation of the effectiveness of EGFR inhibitors erlotinib and gefitinib, an anti-VEGF monoclonal antibody bevacizumab in non-small cell lung cancer (NSCLC). 86 patients received EGFR inhibitors. Objective response (OR) was 18,8 %, tumor growth control (TGC) - 60 %. The median time to progression (MTTP) was 5.3 months, median overall survival (MOS) - 13.3 months. Mutations in the 19th and 21st exons of the EGFR gene were found in 31.6% of cases: deletion in 19th exon (23,7 % and L858R substitution in 21st exon of the EGFR gene (7,9 %. MTTP in patients with EGFR mutations was 13,8 months, in patients without mutations - 2,7 months (p = 0,05); MOS in patients with mutations in EGFR - 21,3 months, and without a mutations - 6,8 months (p = 0,5). The study that examined the efficacy of bevacizumab in combination with standard chemotherapy regimens included 135 patients. OR in the group paclitaxel + carboplatin without bevacizumab was 20 %, with bevacizumab - 43,3 %; MTTP - 4 vs 7 months, MOS - 9,1 vs 15,6 months, respectively (p = 0,00036). A similar comparative analysis was performed for the regimen gemcitabine + cisplatin in combination with or without bevacizumab. OR in the group without bevacizumab was 24 %, with bevacizumab - 47 %. MTTP was 5 vs 7 months (p = 0,023), the MOS - 7,8 vs 15,8 months, respectively (p = 0,00085). Tyrosine kinase inhibitors are effective in NSCLC, but their administration is justified mainly in the case of mutations in EGFR. The addition of bevacizumab to standard chemotherapy improves outcomes in patients with NSCLC.

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