Maintenance treatment is entrenched in the management of metastatic adenocarcinoma, but the choice of regimen varies. GOs who use carboplatin/pemetrexed/bevacizumab are most likely to employ pemetrexed/bevacizumab as maintenance, as does 
Dr Wakelee. For those choosing the ECOG-E4599 regimen up front, including Dr Ramalingam, bevacizumab maintenance is the usual choice. Until 
the ongoing ECOG-E5508 trial confirms or refutes the suggestion from PointBreak of a benefit with combined maintenance with pemetrexed/bevacizumab, clinicians must rely on clinical judgment to make this complex decision.

Ciuleanu T et al. Maintenance pemetrexed plus best supportive care versus placebo plus best supportive care for non-small-cell lung cancer: A randomised, double-blind, phase 3 study. Lancet 2009;374(9699):1432-40. Abstract

Patel JD et al. PointBreak: A randomized phase III study of pemetrexed plus carboplatin and bevacizumab followed by maintenance pemetrexed and bevacizumab versus paclitaxel plus carboplatin and bevacizumab followed by maintenance bevacizumab in patients with stage IIIB or IV nonsquamous non-small-cell lung cancer. J Clin Oncol 2013;31(34):4349-57. Abstract

Sandler A et al. Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer. N Engl J Med 2006;355(24):2542-50. Abstract