The efficacy of bevacizumab plus paclitaxel as first-line treatment for HER2-negative metastatic breast cancer: a meta-analysis of randomized controlled trials.

Although both bevacizumab and paclitaxel significantly improve the efficacy of chemotherapy for human epidermal growth factor receptor 2 (HER2)-negative patients with metastatic breast cancer (MBC), little have changed with overall survival rates when they have been used alone or combined with other chemotherapy. Thus, a meta-analysis was conducted to evaluate the efficacy of bevacizumab combined with paclitaxel in HER2-negative MBC patients. Pubmed and Embase were systematically reviewed for studies published up to September 2013 in which bevacizumab plus paclitaxel were compared with other chemotherapy. Primary outcomes comprised overall survival (OS), progression-free survival (PFS), and objective response rate (ORR). Eight phase II/III clinical trials met the inclusion criteria, with a total of 3,758 patients. The pooled results showed that combination of bevacizumab and paclitaxel significantly improved the PFS (HR = 0.63, 95% CI, 0.55-0.73, P = 0.011), ORR (RR = 1.28, 95% CI, 0.96-1.70, P = 0.0), but had no effect on OS (HR = 0.91, 95% CI, 0.81-1.01, P = 0.855). The meta-analysis confirms the benefits of bevacizumab-paclitaxel combination therapy in HER2 negative metastatic breast cancer, with an improvement in both progression free survival and objective response rate. However, no significant OS benefit was observed.