Association Between Endothelial Progenitor Cells and Treatment Response in Non-Squamous Non-small Cell Lung Cancer Treated with Bevacizumab

Anticancer Res. 2017 Oct;37(10):5565-5571. doi: 10.21873/anticanres.11989.


Background/aim: To investigate the association between the number of circulating endothelial progenitor cells (EPCs) in non-squamous non-small cell lung cancer (NSCLC) and disease outcome, in combination chemotherapy with and without bevacizumab.

Materials and methods: We retrospectively identified 25 non-squamous NSCLC cases, and divided them into high-EPC and low-EPC groups. Within each group, we compared disease outcomes, with or without the administration of bevacizumab.

Results: In the high-EPC group, chemotherapy with bevacizumab produced a significantly higher tumor reduction rate and objective response rate, with significantly longer progression-free survival, compared to chemotherapy without bevacizumab (p<0.001, p=0.010, and p<0.001, respectively). However, in the low-EPC group, there were no significant differences in disease outcomes in groups with versus those without bevacizumab.

Conclusion: The number of EPCs may be a useful biomarker to guide decision-making in the use of bevacizumab in non-squamous NSCLC.

Keywords: Non-squamous non-small-cell lung cancer; bevacizumab; chemotherapy; endothelial progenitor cell; tumor angiogenesis.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Angiogenesis Inhibitors / therapeutic use*
  • Angiogenic Proteins / blood
  • Bevacizumab / therapeutic use*
  • Biomarkers, Tumor / blood
  • Carcinoma, Non-Small-Cell Lung / blood
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Disease Progression
  • Disease-Free Survival
  • Endothelial Progenitor Cells / drug effects*
  • Endothelial Progenitor Cells / metabolism
  • Endothelial Progenitor Cells / pathology
  • Humans
  • Kaplan-Meier Estimate
  • Lung Neoplasms / blood
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome


  • Angiogenesis Inhibitors
  • Angiogenic Proteins
  • Biomarkers, Tumor
  • Bevacizumab