Bevacizumab in the treatment of five patients with breast cancer and brain metastases: Japan Breast Cancer Research Network-07 trial

Daigo Yamamoto,^1,3 Satoru Iwase,² Yu Tsubota,¹ Noriko Sueoka,¹ Chizuko Yamamoto,³ Kaoru Kitamura,⁴ Hiroki Odagiri,⁵ Yoshinori Nagumo<sup>6

1</sup>Department of Surgery, Kansai Medical University, Hirakata, Osaka, ²Department of Palliative Medicine, University of Tokyo Hospital, Tokyo, ³Department of Internal Medicine, Seiko Hospital, Neyagawa, Osaka, ⁴Breast Unit, Nagumo Clinic, Fukuoka, ⁵Department of Surgery, Hirosaki National Hospital, Hirosaki, ⁶Breast Unit, Nagumo Clinic, Tokyo, Japan

Background: Brain metastases from breast cancer occur in 20%–40% of patients, and the frequency has increased over time. New radiosensitizers and cytotoxic or cytostatic agents, and innovative techniques of drug delivery are still under investigation.
Methods: Five patients with brain metastases who did not respond to whole-brain radiotherapy and then received bevacizumab combined with paclitaxel were identified using our database of records between 2011 and 2012. The clinicopathological data and outcomes for these patients were then reviewed.
Results: The median time to disease progression was 86 days. Of five patients, two (40%) achieved a partial response, two had stable disease, and one had progressive disease. In addition, one patient with brain metastases had ptosis and diplopia due to metastases of the right extraocular muscles. However, not only the brain metastases, but also the ptosis and diplopia began to disappear after 1 month of treatment. The most common treatment-related adverse events (all grades) were hypertension (60%), neuropathy (40%), and proteinuria (20%). No grade 3 toxicity was seen. No intracranial hemorrhage was observed.
Conclusion: We present five patients with breast cancer and brain metastases, with benefits from systemic chemotherapy when combined with bevacizumab.

Keywords: brain, bevacizumab, metastatic breast cancer