Bevacizumab as first-line treatment in HER2-negative advanced breast cancer: Pros and cons

Valentina Sini, Alessandra Cassano, Domenico Corsi, Michele De Laurentiis, Teresa Gamucci, Mariella Mauri, Giuseppe Naso, Mario Roselli, Enzo Maria Ruggeri, Giuseppe Tonini, Patrizia Vici, Germano Zampa, Paolo Marchetti

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose: Bevacizumab, a humanized, anti-vascular endothelial growth factor-A monoclonal antibody, has shown efficacy in a number of cancers. However, its use in metastatic breast cancer (MBC) remains controversial. Methods: A literature review using the PubMed database was performed to update the currently available clinical trials evidence on bevacizumab in the first-line treatment of breast cancer. In addition, the proceedings of selected oncology annual meetings were searched for relevant presentations. Results: This article reviews the available evidence for bevacizumab as first-line therapy for MBC and discusses its current and future applicability in the management of MBC. Three phase III trials (ECOG-2100, AVADO, RIBBON-1) demonstrated that the addition of bevacizumab to chemotherapy is well-tolerated and improves progression-free survival and objective response rates in the first-line setting. These findings were supported by a large clinical practice-based study (ATHENA) and a recent clinical trial in which bevacizumab added to paclitaxel showed notable activity in triplenegative MBC. However, bevacizumab has thus far not demonstrated a significant benefit in overall survival. Conclusions: The addition of bevacizumab to chemotherapy is well-tolerated and produces substantial improvements in overall response rate and progression-free survival, compared with chemotherapy alone, in advanced HER2-negative breast cancer. Nevertheless, it has thus far not demonstrated a significant benefit in overall survival. Whether prolongation of progression-free survival is enough to consider bevacizumab efficacious is unclear. Based on the available clinical trials results, bevacizumab is a part of the complex therapeutic strategy of advanced HER2-negative breast cancer.

Original languageEnglish
Pages (from-to)472-480
Number of pages9
JournalTumori
Volume102
Issue number5
DOIs
Publication statusPublished - Sep 1 2016

Keywords

  • Antineoplastic therapy
  • Bevacizumab
  • First-line therapy
  • Metastatic breast cancer
  • Overall survival
  • Triple-negative breast cancer

ASJC Scopus subject areas

  • Medicine(all)
  • Oncology
  • Cancer Research

Fingerprint Dive into the research topics of 'Bevacizumab as first-line treatment in HER2-negative advanced breast cancer: Pros and cons'. Together they form a unique fingerprint.

Cite this