Continuation of bevacizumab and addition of hormone therapy following weekly paclitaxel therapy in HER2-negative metastatic breast cancer
Authors Redondo A, Martínez V, Zamora P, Castelo B, Pinto A, Cruz P, Higuera O, Mendiola M, Hardisson D, Espinosa E
Received 4 July 2014
Accepted for publication 4 September 2014
Published 27 November 2014 Volume 2014:7 Pages 2175—2181
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 4
Editor who approved publication: Dr Faris Farassati
Andrés Redondo,1,* Virginia Martínez,1,* Pilar Zamora,1 Beatriz Castelo,1 Alvaro Pinto,1 Patricia Cruz,1 Oliver Higuera,1 Marta Mendiola,2 David Hardisson,3 Enrique Espinosa1
1Medical Oncology Department, 2Translational Oncology and Molecular Pathology Laboratory, 3Pathology Department, University Hospital La Paz (IdiPAZ), Madrid, Spain
*These authors contributed equally to this work
Background: Bevacizumab plus taxane chemotherapy improves progression-free survival (PFS) versus taxane monotherapy in the first-line treatment of HER2-negative metastatic breast cancer (MBC) and appears promising in the second-line setting. This retrospective analysis evaluated the efficacy and safety of this combination in a real-world setting.
Patients and methods: Eligible patients received bevacizumab (10 mg/kg days 1 and 15, every 28 days) plus paclitaxel (80 mg/m2 days 1, 8, and 15, every 28 days) as first-line therapy for MBC, or as subsequent lines, including bevacizumab continuation therapy, at La Paz University Hospital between August 2007 and October 2012. End points included objective response rate (ORR), PFS, overall survival (OS), and safety.
Results: Seventy-eight patients were included. Median PFS was 12.8 months for patients receiving first-line treatment and 9.3 months for subsequent lines. Forty-five patients (57.7%) continued bevacizumab after stopping paclitaxel, and had significantly longer PFS and OS than those who did not (hazard ratio [HR] 0.40, 95% confidence interval [CI] 0.248–0.653, P<0.001; HR 0.39, 95% CI 0.218–0.710, P=0.002; respectively). In the continuation phase, estrogen receptor-positive patients had longer PFS and OS when receiving hormone therapy plus bevacizumab versus patients receiving only bevacizumab (HR 0.50, 95% CI 0.24–1.04, P=0.06; HR 0.43, 95% CI 0.16–1.16, P=0.09; respectively). Thirty-five patients (44.9%) reported grade 3–4 adverse events.
Conclusion: Bevacizumab plus paclitaxel was effective in HER2-negative MBC. Continuation of bevacizumab and addition of hormone therapy following paclitaxel therapy could be beneficial.
Keywords: bevacizumab, first line, maintenance, advanced breast cancer, hormone therapy
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