A case of advanced lung adenocarcinoma with cavity formation shrunken by bevacizumab added on the 3rd course of 6th-line chemotherapy

A 65-year-old man was pointed out to have an abnormal lung shadow by chest radiograph in a medical examination in 2007. An extensive examination diagnosed him as a case of advanced lung adenocarcinoma. He was treated by chemotherapy up to the 5th-line (cisplatin+docetaxel-→CPT-11+S-1-→amrubicin- →gemcitabine+vinorelbine-→pemetrexed), and the evaluation after the 5th-line treatment revealed disease progression. As he still maintained good performance status, the 6th-line treatment with carboplatin (AUC6, day 1 ) + paclitaxel (200 mg/m², day 1) (Q3W) was administered in March, 2010. The tumor size had been increasing slightly after 2 courses of chemotherapy, although it was within the range of stable disease. Therefore, bevacizumab (15 mg/kg, day 1) was added after the 3rd course of treatment, and the tumor began shrinking obviously with cavity formation. Although the positioning of bevacizumab has not been established after 2nd-line treatment for advanced non-small cell lung carcinoma, we experienced a case of good tumor response by adding the bevacizumab in the middle of the 6th-line chemotherapy.