- Patients and physicians prefer capecitabine+bevacizumab (chemo- plus antiangiogenic therapy; Cap+Bev) over everolimus+exemestane (antihormonal therapy; Eve+Exe) as first-line therapy for hormone receptor-positive (HR+)/HER2-negative advanced breast cancer.
- Cap+Bev revealed longer first-line PFS; QoL was similar.
Why this matters
- Cap+Bev is favored therapy, in contrast to Exe+Eve, which is first-line therapy according to guidelines.
- Open-label, randomized, controlled, multicenter, 2-group, cross-over, phase 4 IMPROVE trial conducted at 26 German sites (N=77).
- Group A: Cap+Bev for 12 weeks, cross-over to Eve+Exe for another 12 weeks.
- Group B: Eve+Exe for 12 weeks, cross-over to Cap+Bev for 12 weeks.
- Funding: Novartis Pharma GmbH.
- According to the Patient Preference Questionnaire, patients preferred Cap+Bev (61.5%) over Eve+Exe (15.4%); 23.1% were indecisive.
- According to the Physician Preference Questionnaire, physicians preferred Cap+Bev (58.1%) over Eve+Exe (32.3%).
- Group A had longer median first-line PFS (11.1 months for group A vs 3.5 months for group B; P=.0008)
- No differences between groups in median second-line PFS (3.7 vs 3.6 months for group B; P=.8345) and median OS (28.8 months for group A and 24.7 months for group B; P=.2088).
- QoL was similar across groups.
- No new safety concerns were reported.
- Relatively few patients because of low recruitment rate.
- Open-label design.