Evidence map›Paper›PMID 37226421›Full record

Trial reportCancer medicine2023

Randomized, Phase II study of pemetrexed plus bevacizumab versus pemetrexed alone after treatment with cisplatin, pemetrexed, and bevacizumab in advanced non-squamous, non-small cell lung cancer: TORG (thoracic oncology research group) 1321.

Takashi Kasai, Kiyoshi Mori, Yoichi Nakamura, Nobuhiko Seki, Yasuko Ichikawa, Haruhiro Saito, Tetsuro Kondo, Kazuo Nishikawa, Satoshi Otsu, Akihiro Bessho and 7 more

Open access · goldAbstract readRandomized Controlled TrialClinical Trial, Phase II
In one paragraph

Trial report in Cancer medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
1.8field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 12 institutions in 1 country.

Takashi KasaiDivision of Thoracic Oncology, Department of Medical Oncology, Tochigi Cancer Center, Utsunomiya, Japan.ORCID 0000-0002-3112-4001
Kiyoshi MoriDivision of Thoracic Oncology, Department of Thoracic Diseases, Utsunomiya Memorial Hospital, Utsunomiya, Japan.
Yoichi NakamuraDivision of Thoracic Oncology, Department of Medical Oncology, Tochigi Cancer Center, Utsunomiya, Japan.
Nobuhiko SekiDivision of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan.
Yasuko IchikawaDivision of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan.
Haruhiro SaitoDepartment of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Japan.
Tetsuro KondoDepartment of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Japan.
Kazuo NishikawaDepartment of Medical Oncology, Oita University Faculty of Medicine, Yufu, Japan.
Satoshi OtsuDepartment of Medical Oncology, Oita University Faculty of Medicine, Yufu, Japan.
Akihiro BesshoDepartment of Respiratory Medicine, Japanese Red Cross Okayama Hospital, Okayama, Japan.
Hiroshi TanakaDepartment of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan.
Hiroyuki YamaguchiDepartment of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Takayuki KaburagiDepartment of Respiratory Medicine, Ibaraki Prefectural Central Hospital, Ibaraki Cancer Center, Kasama, Japan.
Hisao ImaiDivision of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Japan.ORCID 0000-0003-3097-4255
Keita MoriDepartment of Biostatistics, Clinical Research Center, Shizuoka Cancer Center, Sunto, Japan.
Junya OhtakeCollaborative Research Laboratory, St. Luke's International University and Hospital, Tokyo, Japan.
Hiroaki OkamotoDepartment of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan.
Kanagawa Prefectural Hospital Organization · JPOita University · JPShizuoka Cancer Center · JPTeikyo University · JPTochigi Cancer Center · JPHyogo Prefectural Cancer Center · JPIbaraki Prefectural Central Hospital · JPNagasaki University · JPNiigata Cancer Center Hospital · JPOkayama Red Cross General Hospital · JPSt. Luke's International Hospital · JPYokohama Municipal Citizen's Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionCisplatin plus pemetrexed followed by pemetrexed is an efficacious platinum combination regimen for advanced non-squamous, non-small cell lung cancer (NSCLC). Data regarding the addition of bevacizumab, especially in maintenance treatment, are insufficient.

methodsEligibility criteria included: no prior chemotherapy; advanced, non-squamous, NSCLC; performance status ≤1; and epidermal growth factor receptor mutation-negative. Patients (N = 108) received induction chemotherapy with cisplatin, pemetrexed, and bevacizumab every 3 weeks for four cycles, and tumor response was needed to confirm four-week response duration. Patients with at least stable disease were randomized to pemetrexed/bevacizumab or pemetrexed alone. The primary endpoint was progression-free survival (PFS) after induction chemotherapy. Myeloid-derived suppressor cell (MDSC) counts of peripheral blood samples were also analyzed.

resultsThirty-five patients each were randomized to the pemetrexed/bevacizumab group and the pemetrexed alone group. PFS was significantly better in the pemetrexed/bevacizumab group than in the pemetrexed alone group (7.0 vs. 5.4 months, hazard ratio: 0.56 [0.34-0.93], log-rank p = 0.023). In patients with partial response to induction therapy, median overall survival was 23.3 months in the pemetrexed alone group and 29.6 months in the pemetrexed/bevacizumab group (log-rank p = 0.077). Pretreatment monocytic (M)-MDSC counts tended to be greater in the pemetrexed/bevacizumab group with poor PFS than in those with good PFS (p = 0.0724).

conclusionsAddition of bevacizumab to pemetrexed as maintenance therapy prolonged PFS in patients with untreated, advanced, non-squamous NSCLC. Furthermore, an early response to induction therapy and pretreatment M-MDSC counts may be related to the survival benefit of the addition of bevacizumab to the combination of cisplatin and pemetrexed.

Indexed as

Carcinoma, Non-Small-Cell LungLung NeoplasmsAntineoplastic Combined Chemotherapy ProtocolsBevacizumabCisplatinHumansPemetrexedTreatment OutcomeBevacizumabCisplatinPemetrexedadvancedbevacizumab maintenance therapycisplatinnon-small cell lung cancernon-squamouspemetrexedPhase II studyrandomized

Identifiers

PMID37226421
PMCPMC10417045
OpenAlexW4378173198

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.