LAUSR

Bevacizumab is an antibody against vascular endothelial growth factor that has been well investigated for glioblastoma, however, has limited proven efficacy. The drug has, however, demonstrated survival benefit in non-small cell lung carcinoma, renal cell carcinoma and colorectal carcinoma. We provide an overview of its use in the United States for select cancers. We queried the IQVIA database for all cases of glioblastoma diagnosed between January 2014 and June 2018 to analyze the use of bevacizumab for glioblastoma, non-small cell lung carcinoma, and colorectal carcinoma in the United States, and was compared to the standard of care for each indication (temozolomide for glioblastoma, pemetrexed for non-small cell lung carcinoma, and oxaliplatin for colorectal carcinoma). A total of 85,351 patients were treated for glioblastoma as captured by IQVIA. Bevacizumab was prescribed in 17,958 patients, with a projected median annual total of 3,718 patients. The use of bevacizumab for glioblastoma during the study period decreased from 2014 to 2018 (p< 0.0001). The use of temozolomide has remained stable since 2014 to 2018 (p=0.49). For non-small cell lung cancer, we saw a significant decrease in the use of both bevacizumab and pemetrexed (p< 0.0001), with bevacizumab being used in less than 2% of the cases since 2017. For colorectal carcinoma, the use of bevacizumab has overall decreased with a peak use in 2016 (p< 0.0001). The use of oxaliplatin has increased (p< 0.0001). Our findings demonstrated a decreased use of bevacizumab in oncology for three indications, likely associated with a changing role due to the benefit of novel therapy such as immunotherapy. The use of bevacizumab has decreased in glioblastoma, that may be associated to the lack of overall survival benefits in randomized clinical trials.