L Biganzoli1, E Di Vincenzo2, Z Jiang3, M Lichinitser4, Z Shen5, R Delva6, N Bogdanova7, G L Vivanco8, Z Chen9, Y Cheng10, M Just11, M Espié12, J Vinholes13, C Hamm14, D Crivellari15, E Chmielowska16, V Semiglazov17, F Dalenc18, I Smith19. 1. 'Sandro Pitigliani' Medical Oncology Unit, Prato Hospital, Istituto Toscano Tumori, Prato. Electronic address: lbiganzoli@usl4.toscana.it. 2. Cardiologic Unit, Prato Hospital, Prato, Italy. 3. Department of Breast Cancer, Beijing 307 Hospital, Beijing, China. 4. Department of Combined Modality Treatment and Chemotherapy of Malignant Tumors, N. N. Blokhin Russian Oncology Research Center, Moscow, Russia. 5. Department of Breast Surgery, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China. 6. Paul Papin Centre, Angers, France. 7. State Institution P.A. Herzen Moscow, Cancer Research Institute, Moscow, Russia. 8. Medical Oncology Department, Cruces Hospital, Barakaldo, Spain. 9. Department of Medical Oncology, First Affiliated Hospital of Anhui Medical University, He Fei. 10. Department of Internal Medicine, Jilin Cancer Hospital, Changchun, China. 11. Internal Medicine Practice, Bielefeld, Germany. 12. Breast Disease Centre, Hôpital Saint Louis, Paris, France. 13. Oncology Clinic, Porto Alegre, Brazil. 14. Department of Oncology, University of Western Ontario, Windsor, Canada. 15. Division of Medical Oncology, National Cancer Institute, Centro di Riferimento Oncologico, Aviano, Italy. 16. Department of Clinical Oncology, Bydgoszcz Oncology Centre, Bydgoszcz, Poland. 17. Breast Cancer Department, N. N. Petrov Research Institute of Oncology, St Petersburg, Russia. 18. Department of Medical Oncology, Claudius Regaud Institute, Toulouse, France. 19. Breast Unit, Royal Marsden Hospital and Institute of Cancer Research, London, UK.
Abstract
BACKGROUND: There are limited data on treatment outcomes in the growing population of elderly patients with locally recurrent/metastatic breast cancer (LR/mBC). To gain information on first-line bevacizumab combined with chemotherapy in the elderly, we analyzed data from the ATHENA trial in routine oncology practice. PATIENTS AND METHODS: Patients with human epidermal growth factor receptor-2-negative LR/mBC received first-line bevacizumab with standard chemotherapy until disease progression, unacceptable toxicity, or physician/patient decision. We carried out a subgroup analysis of safety and efficacy in patients aged≥70 years. Possible correlations between tolerability and baseline comorbidities or Eastern Cooperative Oncology Group status were explored. RESULTS: Bevacizumab was combined with single-agent paclitaxel in 46% of older patients. Only hypertension and proteinuria were more common in older than in younger patients (grade≥3 hypertension: 6.9% versus 4.2%, respectively; grade≥3 proteinuria: 4.0% versus 1.5%, respectively). Grade≥3 arterial/venous thromboembolism occurred in 2.9% versus 3.3%, respectively. Further analysis revealed no relationship between baseline presence and severity of hypertension and risk of developing hypertension during bevacizumab-containing therapy. Median time to progression was 10.4 months in patients aged≥70 years. CONCLUSIONS: These findings suggest that bevacizumab-containing therapy is tolerable and active in patients aged≥70 years. Hypertension was more common than in younger patients but was manageable. We find no evidence precluding the use of bevacizumab in older patients, including those with hypertension, although age may influence chemotherapy choice.
BACKGROUND: There are limited data on treatment outcomes in the growing population of elderly patients with locally recurrent/metastatic breast cancer (LR/mBC). To gain information on first-line bevacizumab combined with chemotherapy in the elderly, we analyzed data from the ATHENA trial in routine oncology practice. PATIENTS AND METHODS: Patients with human epidermal growth factor receptor-2-negative LR/mBC received first-line bevacizumab with standard chemotherapy until disease progression, unacceptable toxicity, or physician/patient decision. We carried out a subgroup analysis of safety and efficacy in patients aged≥70 years. Possible correlations between tolerability and baseline comorbidities or Eastern Cooperative Oncology Group status were explored. RESULTS:Bevacizumab was combined with single-agent paclitaxel in 46% of older patients. Only hypertension and proteinuria were more common in older than in younger patients (grade≥3 hypertension: 6.9% versus 4.2%, respectively; grade≥3 proteinuria: 4.0% versus 1.5%, respectively). Grade≥3 arterial/venous thromboembolism occurred in 2.9% versus 3.3%, respectively. Further analysis revealed no relationship between baseline presence and severity of hypertension and risk of developing hypertension during bevacizumab-containing therapy. Median time to progression was 10.4 months in patients aged≥70 years. CONCLUSIONS: These findings suggest that bevacizumab-containing therapy is tolerable and active in patients aged≥70 years. Hypertension was more common than in younger patients but was manageable. We find no evidence precluding the use of bevacizumab in older patients, including those with hypertension, although age may influence chemotherapy choice.
Authors: L Manso; F Moreno; R Márquez; B Castelo; A Arcediano; M Arroyo; A I Ballesteros; I Calvo; M J Echarri; S Enrech; A Gómez; R González Del Val; E López-Miranda; M Martín-Angulo; N Martínez-Jañez; C Olier; P Zamora Journal: Curr Oncol Date: 2015-04 Impact factor: 3.677
Authors: Yifeng Zeng; Sreyankar Nandy; Bin Rao; Shuying Li; Andrea R Hagemann; Lindsay K Kuroki; Carolyn McCourt; David G Mutch; Matthew A Powell; Ian S Hagemann; Quing Zhu Journal: J Biophotonics Date: 2019-08-05 Impact factor: 3.207