{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T08:22:01Z","timestamp":1768810921768,"version":"3.49.0"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T00:00:00Z","timestamp":1711324800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Kaohsiung J of Med Scie"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Combining epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) with an anti\u2010 vascular endothelial growth factor (VEGF) agent, bevacizumab or ramucirumab, is indicated for advanced lung adenocarcinoma harboring EGFR mutation. This study aimed to show the real\u2010world data of combination therapy and compare the effectiveness between bevacizumab and ramucirumab in combination with an EGFR\u2010TKI. This retrospective study enrolled 47 patients diagnosed of stage IV lung adenocarcinoma with exon 19 deletion or L858R point mutation, receiving a first\u2010line EGFR\u2010TKI with anti\u2010VEGF agent, including 34 (72%) and 13 (28%) patients receiving bevacizumab and ramucirumab, respectively. The response rate was similar in both groups (<jats:italic>p<\/jats:italic>\u2009=\u20090.38). Patients receiving bevacizumab had similar progression free survival (PFS) as those receiving ramucirumab (median PFS: 21.9 vs. 24.2\u2009months, <jats:italic>p<\/jats:italic>\u2009=\u20090.4871); similar finding was noted in overall survival (OS) (median OS: 33.5\u2009months vs. not reached, <jats:italic>p<\/jats:italic>\u2009=\u20090.4618). Patients receiving ramucirumab experienced a significantly high\u2010grade hypertension compared to those receiving bevacizumab (<jats:italic>p<\/jats:italic>\u2009=\u20090.0351). Multivariable Cox regression analysis found independent risk factors for worse PFS included poorer ECOG performance status, multiple (\u22653) metastatic sites, brain metastasis, and pleural metastasis\/effusion, while the type of anti\u2010VEGF agent was not a risk factor. Pericardial metastasis\/effusion was the only one independent risk factor for worse OS. In summary, ramucirumab may have similar effectiveness as bevacizumab in combination with an EGFR\u2010TKI as first line therapy for advanced lung adenocarcinoma harboring susceptible EGFR mutation. Further large\u2010scale registry\u2010based cohort studies may be needed to validate our findings.<\/jats:p>","DOI":"10.1002\/kjm2.12822","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T08:05:27Z","timestamp":1711353927000},"page":"467-476","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical outcome of bevacizumab or ramucirumab combined with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors as the first line therapy in susceptible EGFR\u2010mutated advanced non\u2010small\u2010cell lung"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8615-0281","authenticated-orcid":false,"given":"Chia\u2010Yu","family":"Kuo","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine Kaohsiung Medical University Hospital, Kaohsiung Medical University  Kaohsiung 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