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Long-term response to first-line bevacizumab-based therapy in patients with metastatic breast cancer: results of the observational “LORENA” study

Authors Redondo A, Ramos Vázquez M, Manso L, Gil Gil MJ, Garau Llinas I, García-Garre E, Rodríguez CA, Chacón JI, López-Vivanco G

Received 6 April 2018

Accepted for publication 12 June 2018

Published 17 September 2018 Volume 2018:11 Pages 5845—5852


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Takuya Aoki

Andrés Redondo,1 Manuel Ramos Vázquez,2 Luis Manso,3 Miguel J Gil Gil,4 Isabel Garau Llinas,5 Elisa García-Garre,6 César A Rodríguez,7 José Ignacio Chacón,8 Guillermo López-Vivanco9

1Clinical Oncology Department, Hospital Universitario La Paz, Madrid, Spain; 2Centro Oncológico de Galicia, A Coruña, Spain; 3Medical Oncology Service, Hospital Universitario 12 de Octubre, Madrid, Spain; 4Institut Catala d’Oncologia – L’Hospitalet, Barcelona, Spain; 5Hospital Son Llatzer, Palma de Mallorca, Spain; 6Hematology and Medical Oncology Department, University Hospital Morales Meseguer, Murcia, Spain; 7Oncology Department, Hospital Universitario de Salamanca-IBSAL, Salamanca, Spain; 8Medical Oncology Department, Hospital Virgen de la Salud, Toledo, Spain; 9Department of Medical Oncology, Hospital Universitario Cruces, Barakaldo, Spain

Randomized controlled trials of the first-line combination of bevacizumab and chemotherapy in patients with metastatic breast cancer (MBC) have shown improvements in tumor response and progression-free survival (PFS).
Objective: The aim of this ambispective, observational study (LORENA) was to describe the clinical characteristics of long-term responders to bevacizumab-based therapy.
Patients and methods: This study consisted of a retrospective and a prospective phase. During the retrospective phase, patients with HER2-negative MBC who were treated with bevacizumab-based first-line therapy were included. During the prospective phase, patients with PFS of ≥12 months were treated according to routine clinical practice procedures. Overall survival (OS) and PFS were estimated using the Kaplan–Meier method. Univariate and multivariate analyses of prognostic factors were performed.
Results: In total, 148 women were included (median age: 50 years; range: 29–81 years). The mean duration of exposure to bevacizumab was 18 months. The majority of patients experienced objective response (complete: 23%; partial: 57%). Median PFS was 22.7 months and median OS was 58.2 months. In multivariate analyses, patients receiving maintenance hormonal therapy (MHT) had longer PFS (P=0.002; hazard ratio [HR] =1.8) and OS (P=0.009; HR=2.0), while patients not previously treated with taxanes had longer OS (P<0.0001; HR =3.3). No unexpected adverse events were observed.
Conclusion: The results of this study suggest, that among long-term responders, first-line bevacizumab-based therapy is more effective in patients who had not been previously treated with taxanes, and that MHT provides additional therapeutic benefits by extending PFS and OS.

bevacizumab, metastatic breast cancer, real-world, maintenance hormonal therapy, taxane

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