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Selecting first-line bevacizumab-containing therapy for advanced breast cancer: TURANDOT risk factor analyses.

Abstract：

BACKGROUND:The randomised phase III TURANDOT trial compared first-line bevacizumab-paclitaxel (BEV-PAC) vs bevacizumab-capecitabine (BEV-CAP) in HER2-negative locally recurrent/metastatic breast cancer (LR/mBC). The interim analysis revealed no difference in overall survival (OS; primary end point) between treatment arms; however, progression-free survival (PFS) and objective response rate were significantly superior with BEV-PAC. We sought to identify patient populations that may be most appropriately treated with one or other regimen. METHODS:Patients with HER2-negative LR/mBC who had received no prior chemotherapy for advanced disease were randomised to either BEV-PAC (bevacizumab 10 mg kg(-1) days 1 and 15 plus paclitaxel 90 mg m(-2) days 1, 8 and 15 q4w) or BEV-CAP (bevacizumab 15 mg kg(-1) day 1 plus capecitabine 1000 mg m(-2) bid days 1-14 q3w). The study population was categorised into three cohorts: triple-negative breast cancer (TNBC), high-risk hormone receptor-positive (HR+) and low-risk HR+. High- and low-risk HR+ were defined, respectively, as having ⩾2 vs ⩽1 of the following four risk factors: disease-free interval ⩽24 months; visceral metastases; prior (neo)adjuvant anthracycline and/or taxane; and metastases in ⩾3 organs. RESULTS:The treatment effect on OS differed between cohorts. Non-significant OS trends favoured BEV-PAC in the TNBC cohort and BEV-CAP in the low-risk HR+ cohort. In all three cohorts, there was a non-significant PFS trend favouring BEV-PAC. Grade ⩾3 adverse events were consistently less common with BEV-CAP. CONCLUSIONS:A simple risk factor index may help in selecting bevacizumab-containing regimens, balancing outcome, safety profile and patient preference. Final OS results are expected in 2015 (ClinicalTrials.gov NCT00600340).

journal_name

Br J Cancer

journal_title

British journal of cancer

authors

Brodowicz T,Lang I,Kahan Z,Greil R,Beslija S,Stemmer SM,Kaufman B,Petruzelka L,Eniu A,Anghel R,Koynov K,Vrbanec D,Pienkowski T,Melichar B,Spanik S,Ahlers S,Messinger D,Inbar MJ,Zielinski C

doi

10.1038/bjc.2014.504

subject

Has Abstract

pub_date

2014-11-25 00:00:00

pages

2051-7

issue

eissn

0007-0920

issn

1532-1827

pii

bjc2014504

journal_volume

111

pub_type

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Selecting first-line bevacizumab-containing therapy for advanced breast cancer: TURANDOT risk factor analyses.