Combined Targeted Therapies for First-line Treatment of Metastatic Triple Negative Breast Cancer-A Phase II Trial of Weekly Nab-Paclitaxel and Bevacizumab Followed by Maintenance Targeted Therapy With Bevacizumab and Erlotinib

Autor: Vijayakrishna K. Gadi, Carol Van Haelst, Eve T. Rodler, Quan Vicky Wu, Mary W. Redman, Isaac C. Jenkins, Jeanne Anderson, Kelsey Baker, Julie R. Gralow, Mitchell Garrison, Larissa A. Korde, Julie C. Smith, Brenda F. Kurland, Jennifer M. Specht, Lynn Symonds, Hannah M. Linden
Rok vydání: 2018
Předmět:
0301 basic medicine
Oncology
Adult
Cancer Research
medicine.medical_specialty
Bevacizumab
Paclitaxel
medicine.medical_treatment
Angiogenesis Inhibitors
Antineoplastic Agents
Triple Negative Breast Neoplasms
Neutropenia
Disease-Free Survival
Drug Administration Schedule
Article
Targeted therapy
Maintenance Chemotherapy
03 medical and health sciences
Erlotinib Hydrochloride
0302 clinical medicine
Breast cancer
Maintenance therapy
Internal medicine
Albumins
Antineoplastic Combined Chemotherapy Protocols
medicine
Clinical endpoint
Humans
Protein Kinase Inhibitors
Aged
Aged
80 and over
business.industry
Endothelial Cells
Induction Chemotherapy
Middle Aged
medicine.disease
Neoplastic Cells
Circulating
Tubulin Modulators
030104 developmental biology
Response Evaluation Criteria in Solid Tumors
030220 oncology & carcinogenesis
Female
Erlotinib
business
medicine.drug
Zdroj: Clinical breast cancer. 19(2)
ISSN: 1938-0666
Popis: Introduction Angiogenesis and epidermal growth factor receptor signaling are potential therapeutic targets in triple negative breast cancer (TNBC). We hypothesized that targeting these critical pathways would prolong progression-free survival with first-line therapy for metastatic TNBC. Patients and Methods We conducted a phase II trial of nab-paclitaxel and bevacizumab, followed by maintenance therapy with bevacizumab and erlotinib, for patients with metastatic TNBC. During induction, the patients received nab-paclitaxel 100 mg/m2 intravenously (days 1, 8, and 15) and bevacizumab 10 mg/kg intravenously (days 1 and 15) every 28 days for 6 cycles. Patients free of progression at 24 weeks received maintenance therapy with bevacizumab 10 mg/kg intravenously every 2 weeks and oral erlotinib 150 mg/d until disease progression. The primary endpoint was progression-free survival (PFS). The secondary endpoints were best overall response, overall survival (OS), and adverse events. We explored the measurement of circulating tumor cells as a prognostic marker. Results A total of 55 evaluable patients were enrolled. The median PFS and OS for the cohort was 9.1 months (95% confidence interval, 7.2-11.1) and 18.1 months (95% confidence interval, 15.6-21.7), respectively. Of the 53 patients with measurable disease, 39 (74%) had experienced a partial response and 10 (19%) had stable disease using the Response Evaluation Criteria In Solid Tumors. The most common toxicities were uncomplicated neutropenia, fatigue, and neuropathy. Decreased circulating tumor cells from baseline to the first assessment correlated with longer PFS and OS. Conclusion Nab-paclitaxel and bevacizumab, followed by maintenance targeted therapy with bevacizumab and erlotinib, resulted in PFS similar to that of other trials. Most patients experienced a partial response (74%). Most patients received maintenance therapy (55%), providing a break from cytotoxic chemotherapy.
Databáze: OpenAIRE
Externí odkaz: