Non-Squamous Non-Small Cell Lung Cancer
Conditions
Brief summary
The purpose of this non-interventional study is the collection and documentation of data on safety and efficacy of intravenous (IV) bevacizumab (Avastin) in addition to platinum-based chemotherapy for first-line treatment in participants with unresectable advanced, metastatic or recurrent non-small cell lung cancer (NSCLC) other than predominantly squamous cell histology with focus on adenocarcinoma and elderly patients in daily routine.
Interventions
Six 3-weeks cycle of IV bevacizumab will be administered for approximately 7 months.
Sponsors
Study design
Eligibility
Inclusion criteria
* Age greater than or equal to (\>=) 18 years * Histologically confirmed predominantly non-squamous NSCLC that is unresectably advanced, metastatic or recurrent (with or without adenocarcinoma) * No contraindications to Avastin® according to the current Summary of Product Characteristics (SmPC) for Avastin® * Therapeutic decision for Avastin® as first line treatment in combination with platinum-based chemotherapy was taken individually and independent of the non-interventional trial.
Exclusion criteria
N/A
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Adverse Drug Reactions (ADRs), Toxicities, Avastin-Related ADRs, and Serious ADRs | Up to 74 months | ADRs were defined as any response to a drug which was noxious and unintended, and which occurred at dose normally used related to the pharmacological properties. Serious ADRs were defined as any untoward medical occurrence or effect that at any dose resulted in death or life-threatening conditions or required hospitalization or prolongation of existing hospitalization, persistent or significant disability or incapacity, congenital anomaly or birth defect or medically important condition. Toxicity was defined as an adverse event that had an attribution (the relationship to investigational agent) of possible, probable or definite. Avastin-related ADRs (an adverse event with a possible relationship or a relationship to the treatment with AVASTIN) were due to Avastin. ADRs includes serious as well as non-serious ADRs. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Cycles of Systemic Therapy | Up to 74 months | Number of cycles of systemic therapy was the mean number of cycles received by participants in combination therapy with Avastin and chemotherapy and with Avastin monotherapy (maintenance). |
| Percentage of Participants With Best Tumor Response Over Time | Up to 74 months | Best tumor response (assessed as per clinical routine of the individual center) was categorized according to the following criteria at the investigator discretion: complete response (CR: commonly defined as disappearance of all target lesions, all non-target lesions, and no new lesion), partial response (PR: commonly defined as at least a 30 percent \[%\] decrease in the sum of the longest diameter \[LD\] of target lesions, no progression in non-target lesion, and no new lesion), stable disease (SD: commonly defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease \[PD\], in addition to no new target lesions). PD: commonly defined as at least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started and not evaluable (NE). |
| Percentage of Participants With Eastern Cooperative Group(ECOG) Performance Status Grades | Up to 74 months | ECOG Performance Status measured on-therapy (time between first dose and last dose date with a 30-day lag) assessed participant's performance status on 5 point scale: 0 is equal to (=) fully active/able to carry on all pre-disease activities without restriction; 1=restricted in physically strenuous activity, ambulatory/able to carry out light or sedentary work; 2=ambulatory (greater than \[\>\] 50% of waking hours \[hrs\]), capable of all self care, unable to carry out any work activities; 3=capable of only limited self care, confined to bed/chair \>50% of waking hrs; 4=completely disabled, cannot carry on any self care, totally confined to bed/chair; 5=dead. |
| Percentage of Participants Who Withdrew or Modified Treatment | Up to 74 months | Percentage of participants who withdrew treatment or experienced at least 1 dose deviation in relation to the planned Avastin therapy were reported. |
| Progression Free Survival (PFS) | Up to 74 months | PFS was defined as the time (months) between the start of therapy and progression (unequivocal progression of existing non-target lesions) or death. Progression: at least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started. PFS was estimated using Kaplan-Meier method. |
| Percentage of Participants Who Died | Up to 74 months | — |
| Overall Survival | Up to 74 months | Overall survival was defined as the time (months) between the start of therapy and the date of death. |
| Percentage of Participants With Disease Control | Up to 74 months | Disease control was defined as having achieved CR (commonly defined as disappearance of all target lesions, all non-target lesions, and no new lesion), PR (commonly defined as at least a 30% decrease in the sum of the LD of target lesions, no progression in non-target lesion, and no new lesion), or SD (commonly defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, in addition to no new target lesions) during the course of observation which were assessed as per investigator discretion. PD: commonly defined as at least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started and NE. |
Countries
Germany
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Bevacizumab Participants received bevacizumab (Avastin) in addition to platinum based chemotherapy for up to 6 cycles (21-day cycles) followed by bevacizumab as a single agent until disease progression. The dose and administration schedule was at the discretion of the treating physician and as per the recommendations given in the current SmPC. | 987 |
| Total | 987 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Administrative Reasons/Other | 231 |
| Overall Study | Cancer Progression | 441 |
| Overall Study | Death From Cancer | 112 |
| Overall Study | Death From Other Cause | 33 |
| Overall Study | Excluded Due to Second Line Treatment | 9 |
| Overall Study | Lost to Follow-up | 33 |
| Overall Study | Missing | 32 |
| Overall Study | Refusal of Treatment/Poor Cooperation | 61 |
| Overall Study | Serious Adverse Drug Reactions | 44 |
Baseline characteristics
| Characteristic | Bevacizumab |
|---|---|
| Age, Continuous | 61.5 years STANDARD_DEVIATION 9.8 |
| Sex/Gender, Customized Female | 396 participants |
| Sex/Gender, Customized Male | 590 participants |
| Sex/Gender, Customized Missing | 1 participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 851 / 987 |
| serious Total, serious adverse events | 110 / 987 |
Outcome results
Percentage of Participants With Adverse Drug Reactions (ADRs), Toxicities, Avastin-Related ADRs, and Serious ADRs
ADRs were defined as any response to a drug which was noxious and unintended, and which occurred at dose normally used related to the pharmacological properties. Serious ADRs were defined as any untoward medical occurrence or effect that at any dose resulted in death or life-threatening conditions or required hospitalization or prolongation of existing hospitalization, persistent or significant disability or incapacity, congenital anomaly or birth defect or medically important condition. Toxicity was defined as an adverse event that had an attribution (the relationship to investigational agent) of possible, probable or definite. Avastin-related ADRs (an adverse event with a possible relationship or a relationship to the treatment with AVASTIN) were due to Avastin. ADRs includes serious as well as non-serious ADRs.
Time frame: Up to 74 months
Population: Analysis population was defined as all participants included in the observational study, regardless of whether they finished it or not.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Bevacizumab | Percentage of Participants With Adverse Drug Reactions (ADRs), Toxicities, Avastin-Related ADRs, and Serious ADRs | ADRs | 88.6 percentage of participants |
| Bevacizumab | Percentage of Participants With Adverse Drug Reactions (ADRs), Toxicities, Avastin-Related ADRs, and Serious ADRs | Toxicities | 88.2 percentage of participants |
| Bevacizumab | Percentage of Participants With Adverse Drug Reactions (ADRs), Toxicities, Avastin-Related ADRs, and Serious ADRs | Avastin-related ADR | 27.0 percentage of participants |
| Bevacizumab | Percentage of Participants With Adverse Drug Reactions (ADRs), Toxicities, Avastin-Related ADRs, and Serious ADRs | Serious ADR | 11.1 percentage of participants |
Number of Cycles of Systemic Therapy
Number of cycles of systemic therapy was the mean number of cycles received by participants in combination therapy with Avastin and chemotherapy and with Avastin monotherapy (maintenance).
Time frame: Up to 74 months
Population: Analysis population was defined as all participants included in the observational study, regardless of whether they finished it.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Bevacizumab | Number of Cycles of Systemic Therapy | Number of cycles with combination therapy | 4.2 cycles | Standard Deviation 1.8 |
| Bevacizumab | Number of Cycles of Systemic Therapy | Total number of cycles | 7.6 cycles | Standard Deviation 7 |
| Bevacizumab | Number of Cycles of Systemic Therapy | Number of cycles with maintenance therapy | 3.4 cycles | Standard Deviation 6.2 |
Overall Survival
Overall survival was defined as the time (months) between the start of therapy and the date of death.
Time frame: Up to 74 months
Population: Analysis population was defined as all participants included in the observational study, regardless of whether they finished it. Here 'number of participants analyzed' = participants assessed for this outcome measure.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Bevacizumab | Overall Survival | 18.4 months | Standard Deviation 0.5 |
Percentage of Participants Who Died
Time frame: Up to 74 months
Population: Analysis population was defined as all participants included in the observational study, regardless of whether they finished it. Here, number of participants analyzed = participants with non-missing tumor response data.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Bevacizumab | Percentage of Participants Who Died | 17.5 percentage of participants |
Percentage of Participants Who Withdrew or Modified Treatment
Percentage of participants who withdrew treatment or experienced at least 1 dose deviation in relation to the planned Avastin therapy were reported.
Time frame: Up to 74 months
Population: Analysis population was defined as all participants included in the observational study, regardless of whether they finished it.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Bevacizumab | Percentage of Participants Who Withdrew or Modified Treatment | 8.8 percentage of participants |
Percentage of Participants With Best Tumor Response Over Time
Best tumor response (assessed as per clinical routine of the individual center) was categorized according to the following criteria at the investigator discretion: complete response (CR: commonly defined as disappearance of all target lesions, all non-target lesions, and no new lesion), partial response (PR: commonly defined as at least a 30 percent \[%\] decrease in the sum of the longest diameter \[LD\] of target lesions, no progression in non-target lesion, and no new lesion), stable disease (SD: commonly defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease \[PD\], in addition to no new target lesions). PD: commonly defined as at least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started and not evaluable (NE).
Time frame: Up to 74 months
Population: Analysis population was defined as all participants included in the observational study, regardless of whether they finished it. Here, number of participants analyzed = participants with non-missing tumor response data.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Bevacizumab | Percentage of Participants With Best Tumor Response Over Time | CR | 2.3 percentage of participants |
| Bevacizumab | Percentage of Participants With Best Tumor Response Over Time | PR | 43.3 percentage of participants |
| Bevacizumab | Percentage of Participants With Best Tumor Response Over Time | SD | 29.4 percentage of participants |
| Bevacizumab | Percentage of Participants With Best Tumor Response Over Time | PD | 10.1 percentage of participants |
| Bevacizumab | Percentage of Participants With Best Tumor Response Over Time | NE | 14.9 percentage of participants |
Percentage of Participants With Disease Control
Disease control was defined as having achieved CR (commonly defined as disappearance of all target lesions, all non-target lesions, and no new lesion), PR (commonly defined as at least a 30% decrease in the sum of the LD of target lesions, no progression in non-target lesion, and no new lesion), or SD (commonly defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, in addition to no new target lesions) during the course of observation which were assessed as per investigator discretion. PD: commonly defined as at least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started and NE.
Time frame: Up to 74 months
Population: Analysis population was defined as all participants included in the observational study, regardless of whether they finished it. Here, number of participants analyzed = participants with non-missing tumor response data.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Bevacizumab | Percentage of Participants With Disease Control | 75.0 percentage of participants |
Percentage of Participants With Eastern Cooperative Group(ECOG) Performance Status Grades
ECOG Performance Status measured on-therapy (time between first dose and last dose date with a 30-day lag) assessed participant's performance status on 5 point scale: 0 is equal to (=) fully active/able to carry on all pre-disease activities without restriction; 1=restricted in physically strenuous activity, ambulatory/able to carry out light or sedentary work; 2=ambulatory (greater than \[\>\] 50% of waking hours \[hrs\]), capable of all self care, unable to carry out any work activities; 3=capable of only limited self care, confined to bed/chair \>50% of waking hrs; 4=completely disabled, cannot carry on any self care, totally confined to bed/chair; 5=dead.
Time frame: Up to 74 months
Population: Analysis population was defined as all participants included in the observational study, regardless of whether they finished it. Here, number of participants analyzed = participants with non-missing tumor response data.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Bevacizumab | Percentage of Participants With Eastern Cooperative Group(ECOG) Performance Status Grades | Grade 3 | 6.2 percentage of participants |
| Bevacizumab | Percentage of Participants With Eastern Cooperative Group(ECOG) Performance Status Grades | Grade 0 | 18.7 percentage of participants |
| Bevacizumab | Percentage of Participants With Eastern Cooperative Group(ECOG) Performance Status Grades | Grade 1 | 50.1 percentage of participants |
| Bevacizumab | Percentage of Participants With Eastern Cooperative Group(ECOG) Performance Status Grades | Grade 2 | 23.2 percentage of participants |
| Bevacizumab | Percentage of Participants With Eastern Cooperative Group(ECOG) Performance Status Grades | Grade 4 | 1.7 percentage of participants |
Progression Free Survival (PFS)
PFS was defined as the time (months) between the start of therapy and progression (unequivocal progression of existing non-target lesions) or death. Progression: at least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started. PFS was estimated using Kaplan-Meier method.
Time frame: Up to 74 months
Population: Analysis population was defined as all participants included in the observational study, regardless of whether they finished it. Here, number of participants analyzed = participants with non-missing tumor response data.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Bevacizumab | Progression Free Survival (PFS) | 7.4 months |