Addition of bevacizumab to conventional therapy improved progression-free survival in HER2-positive breast cancer
Data evaluated by an independent review committee revealed that the addition of bevacizumab to trastuzumab and docetaxel significantly improved progression-free survival in HER2-positive breast cancer, despite findings from an investigator assessment that the improvement was present but statistically non-significant.
Luca Gianni, M.D., director of medical oncology at the San Raffaele Cancer Center in Milano, Italy, presented results from AVEREL, a randomized, phase 3 trial, at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium, held Dec. 6-10, 2011. The trial is designed to evaluate bevacizumab combined with trastuzumab and docetaxel as first-line therapy for HER2-positive, locally recurrent/metastatic breast cancer. The study is the first randomized trial of bevacizumab in this type of breast cancer, according to the researchers.
Patients had measurable or evaluable HER2-positive, locally recurrent/metastatic breast cancer and Eastern Cooperative Oncology Group performance status 0/1 and had not received prior chemotherapy for advanced disease. Patients with central nervous system metastases were excluded.
Researchers enrolled 424 patients from 60 centers during September 2006 to February 2010, with 421 patients receiving treatment. They randomly assigned patients to receive trastuzumab and docetaxel (n=208) or to receive trastuzumab and docetaxel plus bevacizumab (n=216).
At a median follow-up of 26 months, investigator assessment revealed an 18 percent reduction in risk of progression or death with the addition of bevacizumab compared with that of patients who received only trastuzumab and docetaxel. However, an independent review committee analysis found a 28 percent reduction in risk for progression or death with the addition of bevacizumab. Overall, median progression-free survival increased by 2.8 and 2.9 months with bevacizumab according to investigator analysis and independent review committee analysis, respectively.
Gianni said that because there are effective treatments for women with HER2-positive breast cancer, researchers are now examining the precise role of an anti-angiogenic drug in combination with existing therapy.
"The concept of this trial was a test for the benefit observed in early phase 1 and phase 2," Gianni said. "In a way, we confirmed that combining an anti-angiogenic and [other treatment] is a good idea. But now, we have to search the subset of women who have the characteristics associated with benefit from addition of an anti-angiogenic. The key element is looking for a restricted indication that might have a longer-lasting effect than we can observe in AVEREL."
Biomarkers will be important in helping determine the best role for bevacizumab in treating HER2-positive cases, he said.
"The limit in anti-angiogenic therapy is that we treat all participants and we have no hint of what are the tumor characteristics or the patient characteristics that deserve intervention with anti-angiogenic therapy," Gianni said. "We have started some study investigation of biomarkers, and we hope that the AVEREL results, together with other studies, can help in finding ways of restricting indication of bevacizumab to those who could have the right benefit."
Provided by American Association for Cancer Research
- Pertuzumab and trastuzumab combination improved efficacy for women with HER2-positive breast cancer Dec 10, 2010 | not rated yet | 0
- Dual HER2 blockade significantly extends progression-free survival Dec 08, 2011 | not rated yet | 0
- Phase III efficacy data on bevacizumab plus chemotherapy in early breast cancer to be presented Dec 10, 2010 | not rated yet | 0
- Trastuzumab and chemotherapy improved survival in HER2-postive breast and brain cancer patients Jul 18, 2011 | not rated yet | 0
- Phase II study shows new cancer drug combination significantly delays breast cancer progression Sep 25, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Why is zone 1 in liver more prone to ischemic injury?
21 hours ago Hi, Is it because around central vein, there is only deoxygenated blood from the vein where as in the periphery there is hepatic artery. Also why...
How can there be villous adenoma in colon, if there are no villi there
May 22, 2013 As title suggest. Thanks :smile:
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013 Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
- More from Physics Forums - Medical Sciences
More news stories
Breast cancer characterized as "triple negative" carries a poor prognosis, with limited treatment options. In some cases, chemotherapy doesn't kill the cancer cells the way it's supposed to. New research from Western University ...
Cancer 7 hours ago | 5 / 5 (2) | 0
Mayo Clinic researchers have used next generation genomic analysis to determine that some of the more aggressive prostate cancer tumors have similar genetic origins, which may help in predicting cancer progression. The findings ...
Cancer 7 hours ago | not rated yet | 0
Even while being dragged to its destruction inside a cell, a cancer-promoting growth factor receptor fires away, sending signals that thwart the development of tumor-suppressing microRNAs (miRNAs) before it's dissolved, researchers ...
Cancer 8 hours ago | not rated yet | 0 |
Treating pediatric leukemia patients with a liposomal formulation of anthracycline-based chemotherapy at a more intense-than-standard dose during initial treatment may result in high survival rates without causing any added ...
Cancer 12 hours ago | not rated yet | 0
Scientists have uncovered a survival mechanism that occurs in breast cells that have just turned premalignant-cells on the cusp between normalcy and cancers-which may lead to new methods of stopping tumors.
Cancer 13 hours ago | not rated yet | 0 |
(Medical Xpress)—Regulating the distribution of power in neurons is done by a system that makes the national electric grid look simple by comparison. Each neuron has several thousand mitochondria confined ...
7 hours ago | 4.8 / 5 (5) | 0 |
High blood glucose is associated with poor outcomes in hospitalized patients, and use of intensive insulin therapy (IIT) to control hyperglycemia is a common practice in hospitals. But the recent evidence does not show a ...
1 hour ago | not rated yet | 0
A brief visual task can predict IQ, according to a new study. This surprisingly simple exercise measures the brain's unconscious ability to filter out visual movement. The study shows that individuals whose ...
13 hours ago | 4.4 / 5 (9) | 0 |
Teams of highly respected Alzheimer's researchers failed to replicate what appeared to be breakthrough results for the treatment of this brain disease when they were published last year in the journal Science.
11 hours ago | 5 / 5 (1) | 2 |
Scientists at the National Institutes of Health report they have discovered in mouse studies that a small molecule released in the spinal cord triggers a process that is later experienced in the brain as ...
11 hours ago | 5 / 5 (2) | 0 |
Little is known about why asthma develops, how it constricts the airway or why response to treatments varies between patients. Now, a team of researchers at Weill Cornell Medical College, Columbia University Medical Center ...
11 hours ago | not rated yet | 0 |