Dr. Piccirillo on the Safety Profile of Bevacizumab Plus Erlotinib in EGFR+ Nonsquamous NSCLC

Maria Carmela Piccirillo, MD, Clinical Trial Unit, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Napoli, Italy, discusses the safety profile of bevacizumab (Avastin) plus erlotinib (Tarceva) in EGFR-mutated advanced nonsquamous non–small cell lung cancer (NSCLC).

During the 2021 ESMO Congress, the results of the final analysis of the phase 3 BEVERLY trial (NCT02633189) were presented. The findings demonstrated that the addition of bevacizumab to frontline erlotinib significantly prolonged progression-free survival and increased response rates compared with erlotinib alone in Italian patients with EGFR-mutated nonsquamous NSCLC.

Regarding safety, the combination did not modify quality of life or produce unexpected safety signals vs the single-agent regimen. Some bevacizumab-related toxicities, including any-grade and severe hypertension and all-grade proteinuria, were observed more frequently in the combination arm vs the monotherapy arm, Piccirillo says.

Additionally, grade 3 or higher skin rash was observed more frequently with bevacizumab/erlotinib vs erlotinib alone. The increased incidence of this erlotinib-related toxicity is likely because patients receiving bevacizumab/erlotinib had prolonged responses vs erlotinib alone, which meant they received erlotinib for a longer period of time, Piccirillo explains.

Notably, one toxic death from intracranial hemorrhage was reported with bevacizumab/erlotinib, Piccirillo concludes.