Bevacizumab (Avastin^®)
Bevacizumab is an antibody therapy, a class of drugs that bind to and neutralize specific proteins, rendering them inactive. Bevacizumab binds to the angiogenesis-stimulating protein VEGF, which prevents it from activating VEGF receptors on the surface of endothelial cells, the cells that form the inner lining of blood vessels. Without VEGF, endothelial cells are unable to proliferate to form new tumor blood vessels.

The U.S. Food and Drug Administration (FDA) approved bevacizumab to treat newly-diagnosed, advanced nonsquamous NSCLC after a large clinical trial found that adding the drug to standard chemotherapy prolonged survival time by 2 months (10.3 months for chemotherapy alone compared with 12.3 months for chemotherapy plus bevacizumab).²

A second large clinical study conducted primarily in Europe showed that bevacizumab combined with different chemotherapy drugs prolonged the time lung cancer patients lived without their disease getting worse, an endpoint known as progression-free survival (PFS).³ However, the overall survival time did not differ significantly between patients who received bevacizumab plus chemotherapy and those who got chemotherapy and a placebo.

More recently, bevacizumab has been studied with a newer chemotherapy drug called pemetrexed in NSCLC, which has been shown to work well with antiangiogenic agents. A phase 2 trial evaluating bevacizumab combined with pemetrexed/carboplatin showed a median PFS of 7.8 months and a median overall survival of 14 months.⁴ There were no treatment related deaths in this study, and the rate of serious toxicity was minimal. Larger phase 3 trials are being conducted to explore different combinations of bevacizumab and various chemotherapy agents.