The Observation Of Bevacizumab In Advanced Non-squamous Non-small Cell Lung Cancer

The incidence of lung cancer increased year by year,especially non-small cell lung cancer,of which more than three quarters of patients in the disease diagnosis has been in the late,the current efficacy of chemotherapy has reached the bottleneck state.Studies have shown that vascular endothelial growth factor is the main medium of various influencing factors in the process of abnormal vascular proliferation.Bevacizumab as an antiangiogenic drug,can bind to human vascular endothelial growth factor and block its biological activity,thereby inhibiting tumor neovascularization,and then cut off the supply of tumor nutrition,inhibit tumor cell Proliferation and migration.It is the first antiangiogenic drug approved by the FDA for first-line treatment of advanced non-small cell lung cancer.Many studies have confirmed that bevacizumab combined with chemotherapy in the treatment of advanced non-small cell lung cancer can effectively prolong the survival of patients.The application of bevacizumab in practical clinical value is worth further validation and analysis.Objective To observe the efficacy and safety of bevacizumab in the treatment of advanced non-small cell lung cancer.Methods We retrospectively analyzed 48 patients with pathological diagnosis of Stage IV non-squamous non-small cell lung cancer from March 2015 to December 2016.All patients were treated with bevacizumab combined with Pemetrexed/Gemcitabine/ Paclitaxel/Docetaxel/Paclitaxel/Liposome/Vinorelbine±Platinum.The efficacy and adverse reactions were observed and followed up.Results In 48 patients,10 patients(20.8%)had partial response,30(62.5%)had stable disease and 8(16.7%)had disease progression.The objective response rate was 20.8% and the disease control rate was 83.3%.The median PFS was 6.4 months and the median OS was 12.0 months.Results in 36 patients of Pemetrexed,10 Patients(27.8%)had partial response,22 patients(61.1%)had stable disease and 4(11.1%)had progressive disease.The objective response rate was 27.8% and the disease control rate was 88.9%.The median progression-free survival time was 7.3 months and the median overall survival time was 13.1 months.Of the patients who received first-line treatment,the median PFS was 8.8 months and the median OS was 13.9 months.Of the patients who had previously received treatment,the median PFS was 4.3 months and the median OS was 10.3 months.There was a significant difference between the two groups(P<0.05).The median PFS was 9.2 months and the median OS was 14.5 months.Among the patients who received at least four cycles therapy,the median PFS was 9.2 months and the median OS was 14.5 months.Of the other patients,the median PFS was 4.4 months and the median OS was 10.3 months.The difference was statistically significant(P<0.05).The most common adverse reactions were related to chemotherapy,including reducing of blood,nausea and vomiting,liver and kidney dysfunction.Most of them were grade 1-2 and could be improved after treatment.The principal bevacizumab-related adverse events were proteinuria,hemorrhage,hypertension and thromboembolism.Most adverse events were relieved after symptomatic treatment,and severe adverse reactions(grade 3 or above)were rare.Conclusion Bevacizumab combined with chemotherapy can effectively improve the survival of patients with advanced non-squamous non-small cell lung cancer.To maintain the application and continuous use of bevacizumab can significantly prolong the overall survival of the patients.This has certain guiding significance for the clinical application of bevacizumab.The reaction can be tolerated,but we should attach great importance to the history of patients with hemoptysis before the application.