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Br J Cancer. 2014 Nov 25;111(11):2051-7. doi: 10.1038/bjc.2014.504. Epub 2014 Sep 30.

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

Author information

1
Clinical Division of Oncology and Department of Medicine I, Medical University of Vienna and CECOG, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
2
Ráth György u. 7-9, National Institute of Oncology, H-1122 Budapest, Hungary.
3
Department of Oncotherapy, University of Szeged, H-6720 Szeged, Korányi fasor 12, H-6720 Szeged, Hungary.
4
IIIrd Medical Department, Paracelsus Medical University Hospital Salzburg and AGMT, Salzburg, Austria.
5
Institute of Oncology, Clinical Center, University of Sarajevo, Bolnicka 27, 71000 Sarajevo, Bosnia and Herzegovina.
6
Davidoff Center, Rabin Medical Center, Kaplan Street, Petah Tiqwa 49100, Israel.
7
Breast Oncology Institute, Sheba Medical Center, 52621 Tel Hashomer, Ramat-Gan, Israel.
8
Department of Oncology, First Faculty of Medicine and General Teaching Hospital, Charles University Prague, U Nemocnice 2, 128 08 Prague 2, Czech Republic.
9
Department of Breast Tumors, Cancer Institute Ion Chiricuţă, Republicii 34-36, 400015 Cluj-Napoca, Romania.
10
University of Medicine and Pharmacy Bucharest, Soseaua Fundeni, Nr 252, Sector 2, Bucharest 022328, Romania.
11
Department of Medical Oncology, Hospital Serdika, 6 Damyan Gruev street, 1303 Sofia, Bulgaria.
12
Department of Medical Oncology, University Hospital Zagreb-Rebro, Medical University of Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia.
13
Oncology Department, European Health Centre Otwock, ul. Borowa 14/18, 04-500 Otwock, Poland.
14
Department of Oncology, Palacký University Medical School, I. P. Pavlova 6, 775 20 Olomouc, Czech Republic.
15
St Elisabeth Cancer Institute, Heydukova 10, 812 50 Bratislava, Slovak Republic.
16
Biometrics, IST GmbH, Soldnerstrasse 1, 68219 Mannheim, Germany.
17
Oncology Division, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv 64239, Israel.

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).

PMID:
25268370
PMCID:
PMC4260030
DOI:
10.1038/bjc.2014.504
[Indexed for MEDLINE]
Free PMC Article

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