Cases of non-small cell lung cancer with brain metastases treated with bevacizumab in our hospital

Abstract

Objective. The administration of bevacizumab (BEV) for non-small cell lung cancer (NSCLC) patients with brain metastases was contraindicated at the time of its approval in Japan. However, according to the results of several retrospective and prospective studies, the safety and effectiveness of BEV for patients with brain metastasis have been confirmed. Although BEV administration for patients with brain metastases was additionally approved in June 2012 in Japan, the patient selection criteria are unclear. Materials and Methods. Eight NSCLC patients with brain metastasis were treated with BEV-containing regimens in our hospital between June 2012 and July 2015. Results. Patient characteristics were male/female: 4/4 cases, median age: 57 (47-64) years, and adenocarcinoma (Ad)/large-cell neuroendocrine carcinoma (LCNEC): 7/1 cases. The treatment regimens were carboplatin+paclitaxel+BEV/cisplatin+pemetrexed+BEV/erlotinib+BEV: 6/1/1, and the treatment line was 1st/2nd/3rd/4th: 3/3/1/1 cases. All 8 cases had no symptoms due to brain metastasis. Previous therapy before BEV administration included stereotactic radiosurgery (SRS) in two, surgery plus whole brain irradiation in one, whole brain irradiation in one, and no treatment in four cases. Anti-tumor effects on brain metastasis were complete response (CR)/partial response (PR)/stable disease (SD)/progressive disease (PD): 1/3/2/2 cases. No cerebral hemorrhaging was observed in any case. Conclusion. BEV can safely be administered to NSCLC patients with brain metastasis without a risk of cerebral hemorrhaging