Illustration of targeted lung cancer treatment with bevacizumab and chemotherapy

Third-Line Lung Cancer Treatment: Is Chemotherapy Plus Bevacizumab the Answer?

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Elliot Brynn in Health & Wellness August 2025 • 5 min read.

"A new study explores the effectiveness of adding bevacizumab to chemotherapy for advanced non-small cell lung cancer patients who have exhausted other options."


Lung cancer is a leading cause of cancer-related deaths worldwide, with non-small cell lung cancer (NSCLC) accounting for the majority of cases. While first-line treatments like platinum-based chemotherapy and targeted therapies have improved outcomes, many patients eventually experience disease progression. This necessitates the exploration of effective second- and third-line treatment options.

Bevacizumab, a monoclonal antibody that targets vascular endothelial growth factor (VEGF), has shown promise in combination with chemotherapy as a first-line treatment for NSCLC. However, its effectiveness as a salvage treatment, specifically in the third-line setting, has remained unclear.

A recent study published in Oncology Letters sought to compare the efficacy and safety of chemotherapy plus bevacizumab versus chemotherapy alone as a third-line (or continuing) treatment for patients with advanced NSCLC. This article breaks down the study's findings and what they might mean for patients and their treatment plans.

Chemotherapy Plus Bevacizumab: Does It Improve Outcomes?

Illustration of targeted lung cancer treatment with bevacizumab and chemotherapy

The study, a retrospective analysis, examined data from 76 patients with stage IV NSCLC who had previously failed at least two prior systemic regimens. Half of the participants received chemotherapy plus bevacizumab, while the other half received chemotherapy alone. Researchers then matched 38 patients from each group based on various factors like age, sex, smoking history, and EGFR mutation status to ensure a fair comparison. The types of chemotherapy regimens used included gemcitabine, pemetrexed, paclitaxel, and docetaxel.

Key findings from the study revealed several potential benefits of adding bevacizumab to chemotherapy in the third-line setting:

  • Improved Response Rates: Patients receiving the combination therapy experienced a significantly higher objective response rate (ORR) of 23.7% compared to only 5.3% in the chemotherapy-alone group. This means that the tumors of more patients in the combination group shrank or disappeared.
  • Better Disease Control: The disease control rate (DCR), which includes patients with complete response, partial response, or stable disease, was also significantly higher in the chemotherapy-bevacizumab group (65.8%) compared to the chemotherapy-alone group (31.6%).
  • Prolonged Progression-Free Survival: Patients receiving the combination therapy had a longer progression-free survival (PFS) of 3.9 months, compared to 2.2 months for those receiving chemotherapy alone. This indicates that the combination therapy helped delay the progression of the disease.
  • Manageable Side Effects: The incidence of severe adverse events (grade 3 or higher) was low and similar in both groups, suggesting that the combination therapy was generally well-tolerated.
The study also found that bevacizumab treatment was an independent prognostic factor for progression-free survival, and age was identified as an independent risk factor for overall survival. Subgroup analyses further revealed that chemotherapy plus bevacizumab significantly prolonged PFS in certain patient subgroups, including males, current or former smokers, those with adenocarcinoma, EGFR wild-type or unknown status, and those with ≤3 prior regimens.

What This Means for Lung Cancer Patients

While the study has limitations, it suggests that adding bevacizumab to chemotherapy may be a valuable option for NSCLC patients who have progressed on prior treatments and have not previously received bevacizumab. The combination appears to offer improved response rates, better disease control, and prolonged progression-free survival, with manageable side effects. However, it is important to note that this study was retrospective and involved a relatively small number of patients. More prospective, large-scale studies are needed to confirm these findings and further define the optimal use of chemotherapy-bevacizumab in the third-line setting. As always, discuss treatment options with your oncologist to determine the best course of action for your individual circumstances.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

Everything You Need To Know

1

What exactly is Bevacizumab and how does it work to fight cancer?

Bevacizumab is a monoclonal antibody that specifically targets vascular endothelial growth factor, also known as VEGF. VEGF plays a crucial role in angiogenesis, the process by which tumors create new blood vessels to sustain their growth and spread. By blocking VEGF, Bevacizumab inhibits the formation of these new blood vessels, effectively starving the tumor and slowing its progression. This mechanism is important because it directly addresses one of the key ways cancer cells thrive and spread within the body.

2

What does objective response rate (ORR) tell us about how well a treatment is working?

The objective response rate (ORR) measures the percentage of patients whose tumors shrink or disappear entirely in response to a treatment. A higher ORR indicates that a larger proportion of patients are experiencing a positive response to the therapy. In the context of third-line treatment for non-small cell lung cancer (NSCLC), an improved ORR suggests that the treatment is more effective at directly attacking and reducing the tumor burden, leading to better outcomes for patients.

3

What does the disease control rate (DCR) mean, and why is it important?

The disease control rate (DCR) represents the percentage of patients who achieve complete response, partial response, or stable disease during treatment. Stable disease means the tumor has not grown or spread. DCR is a broader measure than ORR, providing a more comprehensive view of treatment effectiveness. A higher DCR suggests that the treatment is helping to control the cancer's growth and spread, even if it doesn't necessarily shrink the tumor significantly. In the context of NSCLC, a higher DCR means more patients are experiencing some level of benefit from the treatment.

4

What is progression-free survival (PFS), and why is it a key factor in evaluating cancer treatments?

Progression-free survival (PFS) is the length of time during and after treatment that a patient lives with the disease without it getting worse. Prolonging PFS is a primary goal in cancer treatment, as it indicates that the therapy is effectively delaying the cancer's progression. A longer PFS generally translates to improved quality of life and potentially longer overall survival. In the context of third-line NSCLC treatment, a prolonged PFS suggests that the treatment is successfully keeping the cancer at bay for a longer period.

5

What kind of chemotherapy drugs are used in these treatment plans?

Some of the chemotherapies used are gemcitabine, pemetrexed, paclitaxel, and docetaxel. These drugs work through different mechanisms to kill cancer cells or stop them from growing. These chemotherapies are often used in combination with other treatments like Bevacizumab to target cancer cells more effectively. The choice of chemotherapy regimen depends on various factors, including the patient's overall health, prior treatments, and the specific characteristics of their cancer. The use of chemotherapy is aimed at directly killing the cancer cells and preventing them from spreading.

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