A Chan1, D W Miles2, X Pivot3. 1. Medical Oncology, Mount Hospital, Perth, Western Australia, Australia. Electronic address: arlene.chan@bigpond.com. 2. Medical Oncology, Mount Vernon Cancer Centre, Middlesex, UK. 3. Medical Oncology, University Hospital J. Minjoz, Besançon, France.
Abstract
BACKGROUND: Taxanes are an established treatment of metastatic breast cancer (mBC). Biological therapies that can be effectively combined with taxanes may provide an alternative to taxane-chemotherapy doublets, which are not suitable for all patients. PATIENTS AND METHODS: Bevacizumab is a humanised mAb against vascular endothelial growth factor (VEGF) which inhibits angiogenesis. This review summarises outcomes from trials evaluating bevacizumab in the first-line treatment of mBC. RESULTS: Bevacizumab demonstrated considerable efficacy in combination with taxane therapy in the first-line treatment of human epidermal growth factor receptor-2 (HER2)-negative mBC in three phase III trials. Improved response rate and progression-free survival (PFS) were also observed in patients who had received taxanes in the adjuvant setting. Bevacizumab-taxane combinations are effective across a broad range of patient subgroups and have greater efficacy than single-agent taxanes in first-line mBC. Importantly, the tolerability of bevacizumab-taxane combinations compares favourably with that of taxanes in combination with other chemotherapy agents. CONCLUSIONS: Bevacizumab-taxane combinations provide an alternative to chemotherapy doublet regimens in first-line mBC, with equivalent efficacy and potentially lower toxicity. Ongoing trials are investigating the efficacy and safety of bevacizumab in various stages of breast cancer and in breast cancer with a range of hormonal or receptor characteristics.
BACKGROUND:Taxanes are an established treatment of metastatic breast cancer (mBC). Biological therapies that can be effectively combined with taxanes may provide an alternative to taxane-chemotherapy doublets, which are not suitable for all patients. PATIENTS AND METHODS: Bevacizumab is a humanised mAb against vascular endothelial growth factor (VEGF) which inhibits angiogenesis. This review summarises outcomes from trials evaluating bevacizumab in the first-line treatment of mBC. RESULTS:Bevacizumab demonstrated considerable efficacy in combination with taxane therapy in the first-line treatment of humanepidermal growth factor receptor-2 (HER2)-negative mBC in three phase III trials. Improved response rate and progression-free survival (PFS) were also observed in patients who had received taxanes in the adjuvant setting. Bevacizumab-taxane combinations are effective across a broad range of patient subgroups and have greater efficacy than single-agent taxanes in first-line mBC. Importantly, the tolerability of bevacizumab-taxane combinations compares favourably with that of taxanes in combination with other chemotherapy agents. CONCLUSIONS:Bevacizumab-taxane combinations provide an alternative to chemotherapy doublet regimens in first-line mBC, with equivalent efficacy and potentially lower toxicity. Ongoing trials are investigating the efficacy and safety of bevacizumab in various stages of breast cancer and in breast cancer with a range of hormonal or receptor characteristics.
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