Safety of Bevacizumab-containing chemotherapy in Non-small-cell Lung Cancer Patients with Brain metastases

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Introduction: Patients with brain metastases have commonly been denied bevacizumab treatment because of the suspected risk of central nervous system (CNS) hemorrhage. Although safety information on bevacizumab treatment of non-small-cell lung cancer (NSCLC) with CNS metastases has been accumulated, its use is still controversial. We conducted the present retrospective study to investigate bevacizumab safety in patients with NSCLC and brain metastases.
Methods: Clinical data of NSCLC patients treated with chemotherapy regimens containing bevacizumab in a single institution from Feb. 2010 to Nov. 2011 were assembled retrospectively from medical records. Hematologic toxicity, non-hematologic toxicity, progression-free survival (PFS), and overall survival (OS) were analyzed.
Results: Fifty two patients were included in this analysis of whom 10 had brain metastases. Incidence of grade ≥3 major bleeding events such as CNS hemorrhage and pulmonary hemorrhage were not observed in either group. Neither were there any differences in toxicity profiles between groups. The median OS and PFS of all patients were 13.1 months (95% confidence interval (CI), 10.7 - not reached) and 9.1 months (95% CI, 4.1 - 11.1 months), respectively. No significant differences in median OS or PFS were observed between the two groups.
Conclusion: These data suggest that bevacizumab treatment may be safe for NSCLC with brain metastases and deserves further study.