• Phase III study (N = 939) evaluating 2 commonly employed first-line/maintenance approaches
• OS with Pem/Cb/Bev followed by maintenance Pem/Bev (Arm A) was not superior to that with paclitaxel/Cb/Bev followed by maintenance Bev (Arm B) for patients with advanced nonsquamous NSCLC
• Arm A was found to have a superior PFS to that of Arm B

This much-anticipated first presentation of the so-called PointBreak trial disappointed many observers in that minimal difference was observed between the “Sandler regimen” of carboplatin/paclitaxel/bevacizumab followed by bev maintenance and the “Patel regimen” of carboplatin/pemetrexed/bevacizumab with pemetrexed/bevacizumab maintenance. Interestingly, a modest initial PFS improvement was recorded with carboplatin/pemetrexed/bevacizumab, and that observation in addition to the lack of alopecia has kept many opting for this strategy. A current ECOG trial is specifically testing the critical question not addressed in PointBreak — what are the relative merits of pemetrexed, bevacizumab or the combination as maintenance treatment — in that case after the Sandler regimen.