Re-introduction of Pemetrexed and Cisplatin With Prolonged Angiogenic Blocking by Bevacizumab in Advanced Lung Cancer.

Phase II Study Evaluating the Interest of the Re-introduction of Pemetrexed and Platinum (Cisplatin or Carboplatin) With Prolonged Angiogenic Blocking by Bevacizumab in Non Squamous Non Small Cell Lung Cancer of Advanced Stage.

At present, the treatment of non-squamous cell lung cancer is based on chemotherapy with platinum eventually associated with bevacizumab. A new treatment begins at progression.

In colo-rectal metastatic cancer, it was demonstrated that the first-line of treatment could be administered according to a stop and go strategy respecting therapeutic breaks between sequences of identical treatment. During these therapeutic breaks, a treatment of maintenance is possibly better than an absence of treatment. These plans benefit to the patients in terms of efficiency but also in terms of toxicity, in particular neurological.

The question is to know if this strategy is feasible in lung cancer.

Inclusion Criteria:

• Non squamous non small cell lung cancer histologically or cytologically confirmed with no EGFR mutation.
• Stage IV NSCLC. Patient with cerebral metastasis are eligible if the metastasis is asymptomatic.
• Measurable disease (recist criteria)
• Age ≥18 years
• PS0 or 1

Exclusion Criteria:

• Mixed cancer small cells and non small cells or squamous lung cancer . EGFR mutated cancer
• History of malignant tumour excepted cervical and basocellular cancer and cancer cured for at least 5 years.
• Tumor invaded the big vessels or the proximal visible in TDM.
• History of adjuvant or neoadjuvant chemotherapy