Add-on bevacizumab delays progression in metastatic HR+ breast cancer

  • Martín M & al.
  • Eur J Cancer
  • 2 Jul 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • A pooled analysis of LEA and CALGB 40503 trials finds that adding bevacizumab to endocrine therapy (ET) extends PFS at the expense of greater toxicity in metastatic hormone receptor (HR)-positive breast cancer.
  • PFS benefit did not translate to OS advantage.

Why this matters

  • LEA and CALGB 40503, when analyzed individually, had conflicting results.

Study design

  • Pooled analysis of 2 phase 3 trials of ET with or without bevacizumab (15 mg/kg body weight every 3 weeks).
  • Funding: Genentech; Roche; NIH; others.

Key results

  • Median follow-up, 34 months.
  • Bevacizumab+ET (vs ET) resulted in longer PFS (19 vs 14.3 months; unadjusted HR, 0.77; P=.0016).
    • Subgroup analysis found greater effect in endocrine-sensitive patients (HR, 0.68; P=.0042).
  • Bevacizumab +ET (vs ET) showed superior:
    • Objective response rate, 61% vs 40% (P<.01>
    • Clinical benefit rate, 77% vs 64% (P=.01).
  • No difference between groups for OS.
  • Bevacizumab+ET had higher toxicity (all P<.01>
  • Grade III-IV hypertension: 20.1% vs 2.2%.
  • Proteinuria: 9.3% vs 0%.
  • Cardiovascular: 4.2% vs 0.5%.
  • Liver events: 2.9% vs 0%.

Limitations

  • No availability of CDK 4/6 inhibitors at the time the studies were performed.

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