BEAT-SC Trial Meets Primary End Point in ES-SCLC

The BEAT-SC trial of bevacizumab plus atezolizumab and platinum-based chemotherapy in patients with extensive-stage small cell lung cancer (ES-SCLC) met its primary end point, according to a presentation at the 2024 American Society of Clinical Oncology Meeting.

Yuichiro Ohe, MD, PhD, of the National Cancer Center Hospital in Tokyo, Japan, presented findings from the study during an oral abstract session held on Monday, June 3. Dr. Ohe presented the primary analysis of progression-free survival (PFS) and the first interim analysis for overall survival (OS) from the trial, which is evaluating the efficacy and safety of bevacizumab plus atezolizumab and platinum-based chemotherapy in patients with ES-SCLC from Japan and China.

The study included adults with measurable ES-SCLC who had an Eastern Cooperative Oncology Group performance status of 0 or 1 who had not received previous systemic treatment for ES-SCLC. The researchers randomized patients 1:1 to receive four 21-day cycles of induction therapy with bevacizumab plus atezolizumab, cisplatin or carboplatin, and etoposide (ACE) or placebo plus ACE. The initial regimens were followed by maintenance therapy with bevacizumab plus atezolizumab or placebo plus atezolizumab, respectively. The primary end point was investigator-assessed PFS, with key secondary end points including OS and safety.

The intention-to-treat population included 333 patients with a median age of 65 years. Among the patients, 91.8% had received carboplatin. Nearly all the patients were male (82.6%) and currently or previously smoked (87.6%). More than half (57.7%) of the participants were from China. The median follow-up was 10.2 months.

The median investigator-assessed PFS was 5.7 months in patients who received bevacizumab plus ACE, compared with 4.4 months in those receiving placebo plus ACE (hazard ratio [HR], 0.70; P=.0060). However, the median OS was 13.0 months in patients who received bevacizumab plus ACE, less than the median OS of 16.6 months in those receiving placebo plus ACE (HR, 1.22; P=.2212).

Bevacizumab plus ACE was “well-tolerated” in the safety analysis population of 330 patients, the investigators reported, noting that “no new safety signals were observed,” and treatment-related adverse events were “generally similar between treatment arms.”

Dr. Ohe and colleagues concluded by explaining that the trial met its primary end point of PFS, as adding bevacizumab to ACE significantly increased PFS compared with placebo plus ACE. They also weighed in on the OS data, explaining that the “OS data were immature at the first interim analysis” and that OS follow-up will continue.

Reference

Ohe Y, Han B, Nishio M, et al. BEAT-SC: a randomized phase III study of bevacizumab or placebo in combination with atezolizumab and platinum-based chemotherapy in patients with extensive-stage small cell lung cancer (ES-SCLC). Presented at the 2024 American Society of Clinical Oncology Annual Meeting; May 31-June 4, 2024; Chicago, Illinois.