Bevacizumab and Paclitaxel As First Line Chemotherapy of Her2 Negative Advanced Breast Cancer (Abc): Results of an Observational Institutional Study

Autor: Valérie Laurence, M-E Dujaric, Bernard Asselain, Véronique Diéras, Sophie Piperno-Neumann, C. Le Tourneau, Paul-Henri Cottu, P. Beuzeboc, Suzy Scholl, J-Y Pierga, Thierry Dorval, L. Mignot, Simona Pop
Rok vydání: 2014
Předmět:
Zdroj: Annals of Oncology. 25:iv133
ISSN: 0923-7534
Popis: Background: A pooled analysis of individual patient data from three randomized phase III trials of first-line bevacizumab-containing therapy for HER2-negative ABC (E2100, AVADO and RIBBON1) demonstrated significantly improved PFS and response rate in patients receiving bevacizumab in combination with chemotherapy versus chemotherapy alone. However, there was no significant difference in overall survival (OS). Bevacizumab in combination with paclitaxel was approved in 2008 by the EMEA and in France this option was available for patients treated as first line therapy for ABC. Methods: The purpose of this retrospective study is to explore the pattern of outcomes in a cohort of MBC patients treated with paclitaxel-bevacizumab in a single institution, with the same standard of care, reflecting general oncology practice. Results: From the data base, between July 2008 and July 2011, 116 patients were treated with bevacizumab and paclitaxel. The median age was 52 years (28-84). 17 patients had de novo ABC. Hormonal receptors were positive in 88% of tumours, 12% triple negative disease. The most frequent metastasis sites were: bone (63%), soft tissue (50%), liver 47%, lung (24%). 33% of patients had more than 2 metastatic sites. Amongst 96 patients without disease progression who discontinued paclitaxel, 62 (53%) received endocrine therapy and 22 (19%) oral chemotherapy in combination with bevacizumab. With a median follow-up of 40.7 mths (5.95-61.4), the PFS is 13.2 mths (0.3-60.2) and median OS 37.8 mths (0.4-61). In triple negative population, the PFS was 7.7 mths (2.7-21) and OS 18.7 mths (5-48.7). Safety profile was as expected with this combination: thrombo-embolic events, HTA and proteinuria leading to discontinuation of bevacizumab in 35% of patients. Conclusions: In our cohort, the outcomes of patients look similar to those of phase III trials evaluating bevacizumab as first line therapy in combination with chemotherapy. The role of maintenance therapy after paclitaxel discontinuation is under investigation in randomized trials. The highest research priority with bevacizumab in mBC must be to prospectively evaluate candidate biomarker. Disclosure: J. Pierga: participation to advisory board and symposia Roche Genentech; V. Dieras: Participation advisory board and symposia Roche Genentech Roche grant for statistics/data management. All other authors have declared no conflicts of interest.
Databáze: OpenAIRE
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