Naslov
Selecting first-line bevacizumab-containing therapy for advanced brest cancer: TURANDOT risk factor analyses

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

Izvornik
British journal of cancer (0007-0920) 111 (2014), 11; 2051-2057

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
bevacizumab; metastatic breast cancer; triple-negative breast cancer; risk factor; prognostic index

Sažetak
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. 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. 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. 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).

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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