Infusional fluorouracil, epirubicin, and cisplatin followed by weekly paclitaxel plus bevacizumab in locally advanced breast cancer with unfavorable prognostic features

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Abstract

The objective of this study was to evaluate the clinical and biological activities of bevacizumab in combination with preoperative anthracyclines and taxane-based chemotherapy in locally advanced breast cancer selected for unfavorable prognostic features. Patients with cT2-4c, cN0-2, estrogen and progesterone receptors less than 10% of the cells or cT4d and any estrogen/progesterone receptors expression received four courses of ECF-chemotherapy (epirubicin, cisplatin, fluorouracil as continuous infusion) followed by three courses of weekly paclitaxel in combination with bevacizumab. Thirty patients were included in the study. An objective response, either complete or partial, was observed in 26 patients (87%; 95% confidence interval: 69-96%), stable disease was observed in two patients (7%), and two patients (7%) progressed. A pathological complete response was obtained in 10 patients (33%; 95% confidence interval: 17-53%). Side effects related to bevacizumab with grade ≥ 2 included headache and hypertension. A nonstatistical significant decrease in the median value of circulating endothelial cells was observed at surgery (3.0/μl vs. 5.7/μl, P=0.19). In conclusion, high rates of both clinical and pathological responses with anthracycline-containing chemotherapy followed by weekly paclitaxel plus bevacizumab were observed in locally advanced breast cancer with unfavorable prognostic features. A non-negligible rate of progressive disease was observed, suggesting careful monitoring of the patients. Further studies evaluating the potential benefit of bevacizumab in neoadjuvant treatment need to be tested.

Original languageEnglish
Pages (from-to)197-203
Number of pages7
JournalAnti-Cancer Drugs
Volume20
Issue number3
DOIs
Publication statusPublished - Mar 2009

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Epirubicin
Paclitaxel
Fluorouracil
Cisplatin
Breast Neoplasms
Anthracyclines
Progesterone Receptors
Drug Therapy
Estrogen Receptors
Confidence Intervals
Neoadjuvant Therapy
Physiologic Monitoring
Headache
Bevacizumab
Endothelial Cells
Hypertension

Keywords

  • Antiangiogenesis
  • Circulating endothelial cells
  • Endocrine receptor negative
  • Inflammatory breast cancer

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Cancer Research
  • Oncology

Cite this

@article{e0336ad20aff46a8a03160c3270512c6,
title = "Infusional fluorouracil, epirubicin, and cisplatin followed by weekly paclitaxel plus bevacizumab in locally advanced breast cancer with unfavorable prognostic features",
abstract = "The objective of this study was to evaluate the clinical and biological activities of bevacizumab in combination with preoperative anthracyclines and taxane-based chemotherapy in locally advanced breast cancer selected for unfavorable prognostic features. Patients with cT2-4c, cN0-2, estrogen and progesterone receptors less than 10{\%} of the cells or cT4d and any estrogen/progesterone receptors expression received four courses of ECF-chemotherapy (epirubicin, cisplatin, fluorouracil as continuous infusion) followed by three courses of weekly paclitaxel in combination with bevacizumab. Thirty patients were included in the study. An objective response, either complete or partial, was observed in 26 patients (87{\%}; 95{\%} confidence interval: 69-96{\%}), stable disease was observed in two patients (7{\%}), and two patients (7{\%}) progressed. A pathological complete response was obtained in 10 patients (33{\%}; 95{\%} confidence interval: 17-53{\%}). Side effects related to bevacizumab with grade ≥ 2 included headache and hypertension. A nonstatistical significant decrease in the median value of circulating endothelial cells was observed at surgery (3.0/μl vs. 5.7/μl, P=0.19). In conclusion, high rates of both clinical and pathological responses with anthracycline-containing chemotherapy followed by weekly paclitaxel plus bevacizumab were observed in locally advanced breast cancer with unfavorable prognostic features. A non-negligible rate of progressive disease was observed, suggesting careful monitoring of the patients. Further studies evaluating the potential benefit of bevacizumab in neoadjuvant treatment need to be tested.",
keywords = "Antiangiogenesis, Circulating endothelial cells, Endocrine receptor negative, Inflammatory breast cancer",
author = "Alessandra Balduzzi and Emilia Montagna and Vincenzo Bagnardi and Rosalba Torrisi and Francesco Bertolini and Patrizia Mancuso and Eloise Scarano and Giuseppe Viale and Paolo Veronesi and Anna Cardillo and Laura Orlando and Aron Goldhirsch and Marco Colleoni",
year = "2009",
month = "3",
doi = "10.1097/CAD.0b013e3283264719",
language = "English",
volume = "20",
pages = "197--203",
journal = "Anti-Cancer Drugs",
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TY - JOUR

T1 - Infusional fluorouracil, epirubicin, and cisplatin followed by weekly paclitaxel plus bevacizumab in locally advanced breast cancer with unfavorable prognostic features

AU - Balduzzi, Alessandra

AU - Montagna, Emilia

AU - Bagnardi, Vincenzo

AU - Torrisi, Rosalba

AU - Bertolini, Francesco

AU - Mancuso, Patrizia

AU - Scarano, Eloise

AU - Viale, Giuseppe

AU - Veronesi, Paolo

AU - Cardillo, Anna

AU - Orlando, Laura

AU - Goldhirsch, Aron

AU - Colleoni, Marco

PY - 2009/3

Y1 - 2009/3

N2 - The objective of this study was to evaluate the clinical and biological activities of bevacizumab in combination with preoperative anthracyclines and taxane-based chemotherapy in locally advanced breast cancer selected for unfavorable prognostic features. Patients with cT2-4c, cN0-2, estrogen and progesterone receptors less than 10% of the cells or cT4d and any estrogen/progesterone receptors expression received four courses of ECF-chemotherapy (epirubicin, cisplatin, fluorouracil as continuous infusion) followed by three courses of weekly paclitaxel in combination with bevacizumab. Thirty patients were included in the study. An objective response, either complete or partial, was observed in 26 patients (87%; 95% confidence interval: 69-96%), stable disease was observed in two patients (7%), and two patients (7%) progressed. A pathological complete response was obtained in 10 patients (33%; 95% confidence interval: 17-53%). Side effects related to bevacizumab with grade ≥ 2 included headache and hypertension. A nonstatistical significant decrease in the median value of circulating endothelial cells was observed at surgery (3.0/μl vs. 5.7/μl, P=0.19). In conclusion, high rates of both clinical and pathological responses with anthracycline-containing chemotherapy followed by weekly paclitaxel plus bevacizumab were observed in locally advanced breast cancer with unfavorable prognostic features. A non-negligible rate of progressive disease was observed, suggesting careful monitoring of the patients. Further studies evaluating the potential benefit of bevacizumab in neoadjuvant treatment need to be tested.

AB - The objective of this study was to evaluate the clinical and biological activities of bevacizumab in combination with preoperative anthracyclines and taxane-based chemotherapy in locally advanced breast cancer selected for unfavorable prognostic features. Patients with cT2-4c, cN0-2, estrogen and progesterone receptors less than 10% of the cells or cT4d and any estrogen/progesterone receptors expression received four courses of ECF-chemotherapy (epirubicin, cisplatin, fluorouracil as continuous infusion) followed by three courses of weekly paclitaxel in combination with bevacizumab. Thirty patients were included in the study. An objective response, either complete or partial, was observed in 26 patients (87%; 95% confidence interval: 69-96%), stable disease was observed in two patients (7%), and two patients (7%) progressed. A pathological complete response was obtained in 10 patients (33%; 95% confidence interval: 17-53%). Side effects related to bevacizumab with grade ≥ 2 included headache and hypertension. A nonstatistical significant decrease in the median value of circulating endothelial cells was observed at surgery (3.0/μl vs. 5.7/μl, P=0.19). In conclusion, high rates of both clinical and pathological responses with anthracycline-containing chemotherapy followed by weekly paclitaxel plus bevacizumab were observed in locally advanced breast cancer with unfavorable prognostic features. A non-negligible rate of progressive disease was observed, suggesting careful monitoring of the patients. Further studies evaluating the potential benefit of bevacizumab in neoadjuvant treatment need to be tested.

KW - Antiangiogenesis

KW - Circulating endothelial cells

KW - Endocrine receptor negative

KW - Inflammatory breast cancer

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DO - 10.1097/CAD.0b013e3283264719

M3 - Article

C2 - 19182679

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JO - Anti-Cancer Drugs

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SN - 0959-4973

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