Skip to main content

Advertisement

SpringerLink
Log in

Efficacy and safety of re-induction therapy with bevacizumab and paclitaxel for metastatic breast cancer

  • Original Article
  • Published:
Breast Cancer Aims and scope Submit manuscript

Abstract

Background

In many trials (including E2100), bevacizumab (Bmab) monotherapy has been continued if toxicity of paclitaxel (PTX) becomes unacceptable during combined treatment with Bmab and PTX. When progression occurs on Bmab monotherapy, one possible option is re-induction with the combination of Bmab and PTX (rBP therapy), because PTX was previously stopped due to toxicity rather than progression. However, we have no data about rBP therapy. Therefore, we investigated the efficacy and safety of rBP therapy in this study.

Methods

We retrospectively investigated 46 patients who started Bmab and PTX between October 2011 and April 2013 at our institution.

Results

After induction with Bmab and PTX, 19 patients subsequently received Bmab monotherapy and 12 patients received rBP therapy. The overall response rate and clinical benefit rate of rBP therapy was 25 % (3/12) and 58 % (7/12), respectively, while the median time to failure of rBP therapy was 174 days (95 % CI 49–273). The median overall survival time of the 46 patients was 777 days (95 % CI 543–NA). Adverse events of grade 3 or worse associated with rBP therapy were neutropenia (25 %), fatigue (8 %), and gastrointestinal bleeding (8 %).

Conclusions

This is the first report about rBP therapy, which was found to be both safe and effective. The OS of all 46 patients in this study (including 12 patients given rBP therapy) was better than in past reports. Selecting rBP therapy for patients with progression on Bmab monotherapy might have contributed to better overall survival, but a randomized controlled trial will be needed to confirm these findings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Hurwitz H, Fehrenbacher L, Novtony W, et al. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med. 2004;350:2335–42.

    Article  CAS  PubMed  Google Scholar 

  2. Bennouna J, Sastre J, Arnold D, Österlund P, Greil R, Van Cutsem E, et al. Continuation of bevacizumab after first progression in metastatic colorectal cancer (ML18147): a randomised phase 3 trial. Lancet Oncol. 2013;14:29–37.

    Article  CAS  PubMed  Google Scholar 

  3. Sandler A, Gray R, Perry MC, Brahmer J, Schiller JH, Dowlati A, et al. Paclitaxel carboplatin alone or with bevacizumab for non small-cell lung cancer. N Engl J Med. 2006;355:2542–50.

    Article  CAS  PubMed  Google Scholar 

  4. Miller K, Wang M, Gralow J, Dickler M, Cobleigh M, Perez EA, et al. Paclitaxel plus bevacizumab versus paclitaxel alone for metastatic breast cancer. N Engl J Med. 2007;357:2666–76.

    Article  CAS  PubMed  Google Scholar 

  5. Perren TJ, Swart AM, Pfisterer J, Ledermann JA, Pujade-Lauraine E, Kristensen G, et al. A phase 3 trial of bevacizumab in ovarian cancer. N Engl J Med. 2011;365:2484–96.

    Article  CAS  PubMed  Google Scholar 

  6. Hershman DL, Lacchetti C, Dworkin RH, Smith EML, Bleeker J, Cavaletti G, et al. Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American Society of Clinical Oncology and Clinical Practice. J Clin Oncol. 2014;32:1941–67.

  7. Cobleigh MA, Langmuir VK, Sledge GW, Miller KD, Haney L, Novonty WF, et al. A Phase I/II dose-escalation trial of bevacizumab in previously treated metastatic breast cancer. Semin Oncol. 2003;30:117–24.

    Article  CAS  PubMed  Google Scholar 

  8. Miles DW, Chan A, Dirix LY, Cortés J, Pivot X, Tomczak P, et al. Phase III study of bevacizumab plus docetaxel compared with placebo plus docetaxel for the first-line treatment of human epidermal growth factor receptor 2–negative metastatic breast cancer. J Clin Oncol. 2010;28:3239–47.

  9. von Minckwitz G, Puglisi F, Cortes J, Vrdoljak E, Marschner N, Zielinski C, et al. Bevacizumab plus chemotherapy versus chemotherapy alone as second-line treatment for patients with HER2-negative locally recurrent or metastatic breast cancer after first-line treatment with bevacizumab plus chemotherapy (TANIA): an open-label, randomised phase 3 trial. Lancet Oncol. 2014;15:1269–78.

    Article  Google Scholar 

  10. Brufsky AM, Hurvitz S, Perez E, Swamy R, Valero V, O’Neill V, et al. RIBBON-2: a randomized, double-blind, placebo-controlled, phase III trial evaluating the efficacy and safety of bevacizumab in combination with chemotherapy for second-line treatment of human epidermal growth factor receptor 2–negative metastatic breast cancer. J Clin Oncol. 2011;29:4286–93.

    Article  CAS  PubMed  Google Scholar 

  11. Yoshinami T, et al. SABCS 2013 Abst#OT3-1-01.

  12. Saji S, et al. ASCO 2014 Abst#TPS657.

Download references

Author information

Authors and Affiliations

  1. Department of Clinical Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3, Nakamichi, Higashinari-ku, Osaka, Japan

    Tetsuhiro Yoshinami, Toshinari Yagi, Naotoshi Sugimoto & Fumio Imamura

  2. Department of Breast Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3, Nakamichi, Higashinari-ku, Osaka, Japan

    Jun Okuno, Nobuyoshi Kittaka, Makoto Ishitobi, Takahiro Nakayama & Yasuhiro Tamaki

Authors
  1. Tetsuhiro Yoshinami
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Toshinari Yagi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jun Okuno
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nobuyoshi Kittaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Makoto Ishitobi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Naotoshi Sugimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Takahiro Nakayama
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yasuhiro Tamaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Fumio Imamura
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tetsuhiro Yoshinami.

Ethics declarations

Conflict of interest

Tetsuhiro Yoshinami has received honoraria for lecture from Chugai. Takahiro Nakayama has received honoraria for lecture from Chugai, Novartis and Astra Zeneca, and research funding from Chugai.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yoshinami, T., Yagi, T., Okuno, J. et al. Efficacy and safety of re-induction therapy with bevacizumab and paclitaxel for metastatic breast cancer. Breast Cancer 24, 147–151 (2017). https://doi.org/10.1007/s12282-016-0686-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12282-016-0686-3

Keywords

Search

Navigation