Risk of hemoptysis in patients with resected squamous cell and other high-risk lung cancers treated with adjuvant bevacizumab Journal Article


Authors: Hellmann, M. D.; Chaft, J. E.; Rusch, V.; Ginsberg, M. S.; Finley, D. J.; Kris, M. G.; Price, K. A. R.; Azzoli, C. G.; Fury, M. G.; Riely, G. J.; Krug, L. M.; Downey, R. J.; Bains, M. S.; Sima, C. S.; Rizk, N.; Travis, W. D.; Rizvi, N. A.; Paik, P. K.
Article Title: Risk of hemoptysis in patients with resected squamous cell and other high-risk lung cancers treated with adjuvant bevacizumab
Abstract: Purpose: Bevacizumab improves survival in lung adenocarcinomas. The potential anti-tumor benefit of bevacizumab in squamous cell lung cancers (SQCLCs) is unknown because bevacizumab is contraindicated in patients with advanced SQCLC due to an increased risk of hemoptysis. The risk of hemoptysis may be eliminated in patients with resected SQCLCs. We evaluated the safety of adjuvant bevacizumab in patients with resected SQCLCs and other lung cancers at high risk of hemoptysis. Methods: As part of a prospective, phase II trial, patients with lung cancers at high risk of hemoptysis (defined by SQCLC histology, tumor near the central blood vessels, or history of hemoptysis) were treated with adjuvant bevacizumab following neo-adjuvant chemotherapy and complete surgical resection. Bevacizumab 15 mg/kg was given once every 3 weeks for up to 1 year. Patients were followed for safety and survival. Results: Thirteen patients with high-risk features were treated: 7 patients had SQCLC, 3 had central tumors, and 3 had previous hemoptysis. No hemoptysis of any grade was seen following treatment with bevacizumab. Five of 13 patients experienced grade 1 bleeding (epistaxis, gum bleeding). Hypertension and lymphopenia were seen. Conclusions: In a cohort of patients with resected lung cancers at high risk of hemoptysis, including those with SQCLC, treatment with adjuvant bevacizumab did not result in hemoptysis of any grade. © 2013 Springer-Verlag Berlin Heidelberg.
Keywords: adult; cancer survival; clinical article; controlled study; treatment outcome; aged; disease-free survival; middle aged; cancer surgery; clinical trial; fatigue; histopathology; carcinoma, squamous cell; bevacizumab; cisplatin; advanced cancer; drug safety; hypertension; adjuvant therapy; postoperative care; combined modality therapy; nuclear magnetic resonance imaging; positron emission tomography; prospective study; adenocarcinoma; edema; computer assisted tomography; multiple cycle treatment; phase 2 clinical trial; cohort studies; neoplasm recurrence, local; anemia; bleeding; lung non small cell cancer; nausea; lung neoplasms; cohort analysis; deep vein thrombosis; antineoplastic activity; high risk patient; docetaxel; hyperglycemia; lymphocytopenia; pneumonia; rash; hyponatremia; karnofsky performance status; adjuvant chemotherapy; acute heart infarction; pleura effusion; hyperbilirubinemia; lung squamous cell carcinoma; endpoint determination; treatment contraindication; angiogenesis inhibitors; lung function test; epistaxis; drug dose sequence; cerebrovascular accident; clinical examination; hypernatremia; hemoptysis; kidney dysfunction; hypertransaminasemia; gingiva bleeding; antibodies, monoclonal, humanized; non-small cell lung cancers; faintness; squamous cell lung cancers
Journal Title: Cancer Chemotherapy and Pharmacology
Volume: 72
Issue: 2
ISSN: 0344-5704
Publisher: Springer  
Date Published: 2013-08-01
Start Page: 453
End Page: 461
Language: English
DOI: 10.1007/s00280-013-2219-5
PROVIDER: scopus
PUBMED: 23811982
PMCID: PMC4653739
DOI/URL:
Notes: - "Export Date: 4 September 2013" - "CODEN: CCPHD" - "Source: Scopus"
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MSK Authors
  1. Camelia S Sima
    204 Sima
  2. Valerie W Rusch
    655 Rusch
  3. Michelle S Ginsberg
    158 Ginsberg
  4. Lee M Krug
    211 Krug
  5. Nabil Rizk
    134 Rizk
  6. Christopher G Azzoli
    105 Azzoli
  7. Katharine A R Price
    10 Price
  8. Naiyer A Rizvi
    157 Rizvi
  9. David John Finley
    39 Finley
  10. Jamie Erin Chaft
    127 Chaft
  11. Matthew G Fury
    93 Fury
  12. William D Travis
    548 Travis
  13. Gregory J Riely
    346 Riely
  14. Paul K Paik
    88 Paik
  15. Robert J Downey
    203 Downey
  16. Manjit S Bains
    229 Bains
  17. Mark Kris
    603 Kris
  18. Matthew David Hellmann
    168 Hellmann