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Multicenter Study
. 2017 Jun;232(6):1571-1578.
doi: 10.1002/jcp.25685. Epub 2016 Nov 30.

A Real-World Multicentre Retrospective Study of Paclitaxel-Bevacizumab and Maintenance Therapy as First-Line for HER2-Negative Metastatic Breast Cancer

Teresa Gamucci  1 , Lucia Mentuccia  1 , Clara Natoli  2 , Isabella Sperduti  3 , Alessandra Cassano  4 , Andrea Michelotti  5 , Luigi Di Lauro  6 , Domenico Sergi  6 , Alessandra Fabi  7 , Maria G Sarobba  8 , Paolo Marchetti  9 , Maddalena Barba  6   10 , Emanuela Magnolfi  1 , Marcello Maugeri-Saccà  6   10 , Ernesto Rossi  4 , Valentina Sini  9 , Antonino Grassadonia  2 , Domenica Pellegrini  7 , Antonino Astone  4 , Cecilia Nisticò  7 , Franco Angelini  11 , Angela Vaccaro  1 , Arianna Pellegrino  12 , Claudia De Angelis  5 , Michela Palleschi  13 , Luca Moscetti  14   15 , Ilaria Bertolini  5 , Simonetta Buglioni  16 , Antonio Giordano  17 , Laura Pizzuti  6 , Patrizia Vici  6
Affiliations
Multicenter Study

A Real-World Multicentre Retrospective Study of Paclitaxel-Bevacizumab and Maintenance Therapy as First-Line for HER2-Negative Metastatic Breast Cancer

Teresa Gamucci et al. J Cell Physiol. 2017 Jun.

Abstract

Bevacizumab in combination with taxanes in HER2-negative metastatic breast cancer (MBC) patients has shown improved progression-free survival (PFS), despite the lack of clear overall survival (OS) benefit. We performed a retrospective analysis to evaluate the impact of paclitaxel-bevacizumab and of maintenance therapy with bevacizumab (BM) and endocrine therapy (ET) in the real-world practice. We identified 314 HER2-negative MBC patients treated in 12 cancer centers. Overall, the median PFS and OS were 14 and 40 months, respectively. Among the 254 patients potentially eligible for BM, 183 received BM after paclitaxel discontinuation until progression/toxicity. PFS and OS were improved in patients who had received BM in comparison with those potentially eligible but who did not receive BM (P< 0.0001 and P = 0.001, respectively). Results were confirmed when adjusting for propensity score. Among the 216 hormone-receptor positive patients eligible for BM, a more favorable PFS and OS were observed when maintenance ET was administered (P < 0.0001). Multivariate analysis showed that PS, BM, number of disease sites and maintenance ET were related to PFS, while response and maintenance ET were related to OS. In hormone-receptor positive patients, BM produced a significant PFS and a trend towards OS benefit only in absence of maintenance ET (P = 0.0007 and P = 0.06, respectively). In the triple-negative subgroup, we observed a trend towards a better OS for patients who received BM (P = 0.06), without differences in PFS (P = 0.21). Our results confirmed the efficacy of first-line paclitaxel-bevacizumab in real-world practice; both BM and maintenance ET significantly improved PFS and OS compared to no maintenance therapies. J. Cell. Physiol. 232: 1571-1578, 2017. © 2016 Wiley Periodicals, Inc.

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Figures

Figure 1
Figure 1
Progression‐free survival (PFS, A) and overall survival (OS, B) in the overall population.
Figure 2
Figure 2
Progression‐free survival (PFS, A) and overall survival (OS, B) according to administration of bevacizumab maintenance (BM) and adjusted for propensity score (PFS, C; OS, D).
Figure 3
Figure 3
Progression‐free survival (PFS, A) and overall survival (OS,B) in hormone‐receptor positive patients according administration of hormonal therapy (ET) at the end of first‐line chemotherapy.
Figure 4
Figure 4
Progression‐free survival (PFS, A) and overall survival (OS, B) in triple‐negative patients according to administration of bevacizumab maintenance (BM).
See this image and copyright information in PMC

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