Background New data released by clinical trials AVADO and RIBBON have questioned the use of Avastin in metastatic breast cancer (MBC). EMA keeps the indication of first line in combination with paclitaxel or capecitabine when taxanes or anthracyclines are not indicated.
Purpose This study explores our single-centre experience to cheque the effectiveness and safety of bevacizumab in MBC in clinical practise.
Materials and Methods Retrospective study of 41 MBC patients treated with bevacizumab and chemotherapy in a Spanish teaching hospital from 07/2008 to 06/2012. Toxic effects were graded according to the National Cancer Institute Common Toxicity Criteria (NCI-CTC). Disease status was assessed according to the Response Evaluation Criteria in Solid Tumors (RECIST). Clinical evaluation included clinical response, time to progression (TTP), and toxicity. Median survival times were estimated from Kaplan–Meier curves. Data analysis was performed using SPSS-17.0.
Results Median age was 59 yrs (34–75). 87.8% of patients had ECOG PS 0–1. Bevacizumab was administered with docetaxel (46.3%), paclitaxel (29.3%), taxane-carboplatin (17.1%) or capecitabine (7.3%). It was used as first line in 19 cases (46.3%), second line in 5 and following lines in 17 cases (41.5%). Sites of metastases were: 26 visceral and 4 skeletal. Overall Response was 46.4% (4.9% Complete and 41.5% Partial). 17.1% had progressive disease. Median TTP: 7.8 months (6.5–9.2;95%CI). Median TTP of first-line paclitaxel-bevacizumab was 11 vs. 7.7 months for the rest of the combinations (P = 0.501). Safety outcomes were similar among treatments. G1–2 toxicities: bleeding (32%), anaemia (21.8%), mucositis (21.9%), diarrhoea (9.7%), hypertension (20%). 1 patient suffered grade 4 hypertension resulting in discontinuation and 2 patients suffered deep vein thromboembolisms. Other non-specific toxicities: neutropenia (31.2% − G3–4 = 7.3%), neuropathy (19.5%), alopecia (24.4%), nausea/vomiting (9.8%).
Conclusions TTP was longer with paclitaxel than with other antineoplastic agents but the difference was not statistically significant. Most of patients in the paclitaxel group were censored as they hadn’t reached progression yet. Toxicity profile was as expected.
No conflict of interest.
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