TY - JOUR
T1 - A systematic review of bevacizumab efficacy in breast cancer
AU - Kümler, Iben
AU - Christiansen, Ole Grummedal
AU - Nielsen, Dorte Lisbet
N1 - Copyright © 2014 Elsevier Ltd. All rights reserved.
PY - 2014/9
Y1 - 2014/9
N2 - Angiogenesis is a key component of cancer growth, invasion and metastasis. Therefore, inhibition of angiogenesis is an attractive strategy for the treatment of cancer.We systematically describe phase II and III clinical trials of bevacizumab for the treatment of breast cancer. Methods: A computer-based literature search was carried out using PUBMED and conference databases. Original phase II and III studies reporting ≥15 patients who received bevacizumab were included. Results: 41 phase II trials were identified in the metastatic setting. Most trials found bevacizumab treatment feasible. Response rates (RR) varied from 0% to 76.5%, time to progression (TTP)/progression free survival (PFS) from 2.4 to 25.3. months and overall survival from 11.5 to more than 38. months. 14 phase III trials including more than 4400 patients with MBC unanimously showed increased RR and PFS, however, no trials demonstrated an OS benefit. In the neoadjuvant setting 23 phase II and III trials were identified. All studies found increased pCR/tpCR but no benefit in terms of OS could be demonstrated. The only study conducted in the adjuvant setting failed to show any survival benefit of bevacizumab. Conclusion: Despite increased response rates in both the metastatic and neoadjuvant setting, bevacizumab has failed to show any OS benefit. Future trials should include identification of robust predictive biomarkers in order to improve our understanding of molecular biomarkers and mechanisms.
AB - Angiogenesis is a key component of cancer growth, invasion and metastasis. Therefore, inhibition of angiogenesis is an attractive strategy for the treatment of cancer.We systematically describe phase II and III clinical trials of bevacizumab for the treatment of breast cancer. Methods: A computer-based literature search was carried out using PUBMED and conference databases. Original phase II and III studies reporting ≥15 patients who received bevacizumab were included. Results: 41 phase II trials were identified in the metastatic setting. Most trials found bevacizumab treatment feasible. Response rates (RR) varied from 0% to 76.5%, time to progression (TTP)/progression free survival (PFS) from 2.4 to 25.3. months and overall survival from 11.5 to more than 38. months. 14 phase III trials including more than 4400 patients with MBC unanimously showed increased RR and PFS, however, no trials demonstrated an OS benefit. In the neoadjuvant setting 23 phase II and III trials were identified. All studies found increased pCR/tpCR but no benefit in terms of OS could be demonstrated. The only study conducted in the adjuvant setting failed to show any survival benefit of bevacizumab. Conclusion: Despite increased response rates in both the metastatic and neoadjuvant setting, bevacizumab has failed to show any OS benefit. Future trials should include identification of robust predictive biomarkers in order to improve our understanding of molecular biomarkers and mechanisms.
KW - Angiogenesis Inhibitors
KW - Antibodies, Monoclonal, Humanized
KW - Antineoplastic Combined Chemotherapy Protocols
KW - Breast Neoplasms
KW - Clinical Trials, Phase II as Topic
KW - Clinical Trials, Phase III as Topic
KW - Female
KW - Humans
KW - Randomized Controlled Trials as Topic
U2 - 10.1016/j.ctrv.2014.05.006
DO - 10.1016/j.ctrv.2014.05.006
M3 - Review
C2 - 24909311
SN - 0305-7372
VL - 40
SP - 960
EP - 973
JO - Cancer Treatment Reviews
JF - Cancer Treatment Reviews
IS - 8
ER -
