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. 2013 Jun 17:5:37-42.
doi: 10.2147/BCTT.S44728. eCollection 2013.

Comparative study analyzing survival and safety of bevacizumab/carboplatin/paclitaxel versus carboplatin/docetaxel in initial treatment of metastatic Her-2-negative breast cancer

Yasser Abdel Kader  1 , Marc Spielmann  2 , Tamer El-Nahas  1 , Amr Sakr  1 , Hassan Metwally  3
Affiliations

Comparative study analyzing survival and safety of bevacizumab/carboplatin/paclitaxel versus carboplatin/docetaxel in initial treatment of metastatic Her-2-negative breast cancer

Yasser Abdel Kader et al. Breast Cancer (Dove Med Press). .

Abstract

Purpose: In view of the previous reports demonstrating the positive outcome of bevacizumab in metastatic breast cancer, we aimed at comparing the role of bevacizumab-based metronomic combination with taxane (paclitaxel) versus a different taxane (docetaxel)-based regimen in addition to carboplatin as initial treatment for metastatic Her-2-negative breast cancer.

Patients and methods: This is a randomized Phase III study comparing the progression-free survival (PFS) and safety in Her-2-negative female patients with initial diagnosis of metastatic breast cancer with World Health Organization performance status of 0-II. Forty-one patients were randomized from September 2008 to July 2009 to receive either; (1) bevacizumab 5 mg/kg day 1 and day 15, carboplatin area under the curve (AUC)-2 day 1, day 8, and day 15, and paclitaxel 60 mg/m(2) day 1, day 8, and day 15 (arm-I); or (2) carboplatin AUC-5 day 1, docetaxel 75 mg/m(2) day 1 (arm-II). The Kaplan-Meier method was used for estimating survival; log-rank test for comparing survival curves. The primary end point was PFS, and secondary end points were overall survival (OS) and safety.

Results: PFS was 10 months in arm I versus 10.2 months in arm II (P = 0.9). The OS rate was similar in both arms: 37.6 months for arm I versus 37.4 months for arm II (P = 0.92). The toxicity revealed higher incidence of hypertension and proteinuria in arm I; however, with higher incidence of grade III-IV neutropenia and neutropenic fever in arm II. No treatment-related mortality was recorded.

Conclusion: Bevacizumab/carboplatin/paclitaxel and carboplatin/docetaxel show comparable PFS and OS with different toxicity profiles.

Keywords: Her-2 negative; bevacizumab; breast cancer; taxanes.

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Figures

Figure 1
Figure 1
Median TTP in both arms. Abbreviation: TTP, time to progression.
Figure 2
Figure 2
WHO PS correlation with TTP in the whole study group. Abbreviations: TTP, time to progression; WHO PS, World Health Organization performance status.
Figure 3
Figure 3
Steroid hormone correlation with TTP in the whole study group. Abbreviations: ER, estrogen receptor; PR, progesterone receptor; TTP, time to progression.
Figure 4
Figure 4
Bone/visceral metastasis correlation with TTP in the whole study group. Abbreviations: TTP, time to progression; visc, visceral.
Figure 5
Figure 5
Bone/visceral metastasis correlation with median OS in the whole study group. Abbreviation: OS, overall survival; visc, visceral.
Figure 6
Figure 6
Median OS in both arms. Abbreviation: OS, overall survival.
Figure 7
Figure 7
Age correlation with median OS in the whole study group. Abbreviation: OS, overall survival.
See this image and copyright information in PMC

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