Evidence map›Paper›PMID 42231603›Full record

ArticleThoracic cancer2026

Systemic Inflammation Modifies the Efficacy of Bevacizumab Added to Atezolizumab Plus Chemotherapy for Advanced Non-Squamous Non-Small Cell Lung Cancer: A Multicenter Retrospective Study.

Keijiro Yamauchi, Kinnosuke Matsumoto, Takayuki Shiroyama, Akihiro Tamiya, Motohiro Tamiya, Akihiro Tsukaguchi, Akito Miyazaki, Kiyohide Komuta, Yasuhiro Mihashi, Hirotomo Machiyama and 15 more

Abstract readMulticenter Study
In one paragraph

Article in Thoracic cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

25 authors.

Keijiro YamauchiDepartment of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, The University of Osaka, Osaka, Japan.ORCID https://orcid.org/0009-0005-2875-9320
Kinnosuke MatsumotoDepartment of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, The University of Osaka, Osaka, Japan.ORCID https://orcid.org/0000-0002-4930-6997
Takayuki ShiroyamaDepartment of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, The University of Osaka, Osaka, Japan.
Akihiro TamiyaDepartment of Internal Medicine, NHO Kinki Chuo Chest Medical Center, Osaka, Japan.
Motohiro TamiyaDepartment of Respiratory Medicine, Osaka International Cancer Institute, Osaka, Japan.
Akihiro TsukaguchiDepartment of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, The University of Osaka, Osaka, Japan.
Akito MiyazakiDepartment of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, The University of Osaka, Osaka, Japan.
Kiyohide KomutaDepartment of Respiratory Medicine, Osaka International Cancer Institute, Osaka, Japan.
Yasuhiro MihashiDepartment of Thoracic Oncology, NHO Osaka Toneyama Medical Center, Osaka, Japan.
Hirotomo MachiyamaDepartment of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, The University of Osaka, Osaka, Japan.
Kensuke KanaokaDepartment of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, The University of Osaka, Osaka, Japan.ORCID https://orcid.org/0000-0002-1266-7043
Tomoki KugeDepartment of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, The University of Osaka, Osaka, Japan.
Yuhei KineharaDepartment of Respiratory Medicine and Clinical Immunology, Nippon Life Hospital, Osaka, Japan.
Nao ShoshiharaDepartment of Respiratory Medicine, Osaka Keisatsu Hospital, Osaka, Japan.
Toshie NikiDepartment of Respiratory Medicine, Nishinomiya Municipal Central Hospital, Nishinomiya, Hyogo, Japan.
Soichiro KatoDepartment of Respiratory Medicine, Ikeda Municipal Hospital, Osaka, Japan.
Yuki NishikawaDepartment of Respiratory Medicine, Toyonaka Municipal Hospital, Osaka, Japan.
Koji AzumaDepartment of Respiratory Medicine, NHO Osaka National Hospital, Osaka, Japan.
Satoshi TanakaDepartment of Respiratory Medicine, Osaka General Medical Center, Osaka, Japan.ORCID https://orcid.org/0000-0002-1854-794X
Akio OsaDepartment of Respiratory Medicine, Kinki Central Hospital, Itami, Hyogo, Japan.
Hidekazu SuzukiDepartment of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan.
Izumi NagatomoDepartment of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, The University of Osaka, Osaka, Japan.
Junji UchidaDepartment of Thoracic Oncology, NHO Osaka Toneyama Medical Center, Osaka, Japan.
Yoshito TakedaDepartment of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, The University of Osaka, Osaka, Japan.
Atsushi KumanogohDepartment of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, The University of Osaka, Osaka, Japan.

Funding

Japan Society for the Promotion of Science 23K15187Japan Society for the Promotion of Science 25K19461
6 · The paper itself

Abstract

introductionBevacizumab, an anti-VEGF antibody, inhibits angiogenesis and modulates the tumor microenvironment. Because systemic inflammation is linked to VEGF activation and immune modulation, it may affect bevacizumab efficacy. However, this relationship remains unclear. We therefore evaluated whether systemic inflammation, assessed via the serum C-reactive protein (CRP) level, modifies survival benefit when adding bevacizumab to chemoimmunotherapy in advanced non-squamous non-small cell lung cancer (NSCLC).

methodsWe retrospectively analyzed patients with advanced non-squamous NSCLC from 13 Japanese institutions receiving first-line atezolizumab plus chemotherapy with or without bevacizumab between December 2018 and December 2022. The primary endpoint was overall survival (OS). The interaction between CRP level (< 1 mg/dL vs. ≥ 1 mg/dL) and bevacizumab treatment was evaluated, and sensitivity analyses were performed to confirm the robustness of our findings.

resultsAmong 193 eligible patients, 109 (56.5%) received bevacizumab. With a median follow-up of 44.2 months, the median OS was 24.5 months in patients with low CRP and 17.3 months in those with high CRP (log-rank test for trend, p = 0.04). Bevacizumab significantly improved OS in patients with high CRP (hazard ratio [HR] 0.63; 95% confidence interval, 0.40-0.99; p = 0.04), but not in those with low CRP (HR 1.22; p = 0.50). The interaction between CRP level and bevacizumab treatment was significant (p = 0.033). Sensitivity analyses supported these results.

conclusionsSystemic inflammation, as assessed by CRP level, may modify the efficacy of bevacizumab in advanced non-squamous NSCLC. These hypothesis-generating findings warrant prospective validation to clarify the role of CRP in treatment stratification.

Indexed as

Antibodies, Monoclonal, HumanizedAntineoplastic Combined Chemotherapy ProtocolsBevacizumabCarcinoma, Non-Small-Cell LungInflammationLung NeoplasmsAgedC-Reactive ProteinFemaleHumansMaleMiddle AgedRetrospective StudiesAntibodies, Monoclonal, HumanizedatezolizumabBevacizumabC-Reactive ProteinatezolizumabbevacizumabC‐reactive proteinpredictive biomarkersystemic inflammation

Identifiers

PMID42231603
PMCPMC13239817

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.