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 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 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/ and Eastern Cooperative Oncology Group performance status 0/1 and had not received prior chemotherapy for advanced disease. Patients with 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 , 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 to those who could have the right benefit."

Related Stories

Recommended for you

Study finds new potential melanoma drug target

date May 02, 2015

A new treatment for melanoma could be on the horizon, thanks to a finding by a UNC Lineberger Comprehensive Cancer Center-led team. In the study, which was published online today in the journal Clinical Ca ...

Surgery for terminal cancer patients still common

date May 02, 2015

The number of surgeries performed on terminally ill cancer patients has not dropped in recent years, despite more attention to the importance of less invasive care for these patients to relieve symptoms and ...

Study provides comprehensive look at brain cancer treatments

date May 01, 2015

Led by the Translational Genomics Research Institute (TGen) and UC San Francisco (UCSF), a comprehensive genetic review of treatment strategies for glioblastoma brain tumors was published today in the Oxford University Press ...

How artificial tanning can lead to melanoma

date May 01, 2015

Young women may be up on the latest fashions and trends as they prepare for prom season. But what many don't know is that the tan that looks oh-so-good with their dress may be the first step toward skin cancer.

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.