Metastatic breast cancer: Bevacizumab slows progression, but has no impact on survival

July 10, 2012

The cancer drug bevacizumab (Avastin) offers only a modest benefit in delaying disease progression in patients with advanced stage breast cancer, according to a systematic review by Cochrane researchers. The researchers assessed the efficacy of bevacizumab in combination with chemotherapy, an established cancer treatment in this indication, and found no overall survival benefit when adding bevacizumab to chemotherapy.

is the most common cause of among women. If it spreads to other parts of the body it is referred to as "metastatic" and the cancer becomes much more difficult to treat. One promising approach is drugs that target vascular endothelial growth factor (VEGF), a key molecule mediating growth of blood vessels in tumours. At present, trials of drugs that target VEGF are limited to bevacizumab, which is the first drug of this type to be approved for metastatic breast cancer.

To assess the clinical value of bevacizumab in combination with other established chemotherapy drugs, the researchers gathered evidence from seven trials involving a total of 4,032 patients, most of whom had metastatic breast cancer. They found that adding bevacizumab to established drug regimens increased the time to tumour progression or death by between one and six months, depending on the prescribed. However, the researchers found that adding bevacizumab to first- or second-line treatments did not increase overall survival or quality of life.

"At best, adding bevacizumab to standard chemotherapy appears to offer a modest benefit for those with metastatic breast cancer," said lead researcher, Anna Dorothea Wagner, of the Fondation du Centre Pluridisciplinaire d'Oncologie, University Hospital Lausanne, Switzerland. "Whether it can truly be of benefit to the patient is debatable, because it only briefly prolongs progression of the disease. No impact on the patient's overall survival or quality of life has been demonstrated."

According to the researchers, clinical trials testing new drugs for advanced stage breast cancer should follow patients until death in order to understand the impact of new treatments on survival. "The fact that an increase in progression-free survival does not lead to an increase in overall survival suggests that progression-free survival may not be a reliable surrogate for clinical trials in metastatic cancer," said Wagner.

In 2011, the US Food and Drug Administration (FDA) removed breast cancer from indications on the label of , due to concerns about serious side effects and doubts about its benefit in terms of overall survival. By contrast, it is approved for first-line treatment of metastatic breast cancer in Europe, in combination with the cancer drug paclitaxel, as well as in combination with capecitabine for patients with metastatic cancer who are not eligible for treatment with taxanes or anthracyclines.

More information: Wagner AD, Thomssen C, Haerting J, Unverzagt S. Vascular-endothelial-growth-factor (VEGF) targeting therapies for endocrine refractory or resistant metastatic breast cancer. Cochrane Database of Systematic Reviews 2012, Issue 7. Art. No.: CD008941. DOI: 10.1002/14651858.CD008941.pub2

Related Stories

US revokes Roche's Avastin for breast cancer

November 18, 2011

US health officials on Friday revoked the authorization of Roche's Avastin for breast cancer treatment, saying it concluded the drug had "not been shown to be safe and effective for that use."

Drug cocktail boosts ovarian cancer survival time

June 2, 2012

A drug cocktail that combines chemotherapy with Avastin was shown to double the amount of time patients lived without progression of ovarian cancer, according to research released Saturday.

ASCO: Continuing avastin with 2nd-line chemo ups survival

June 5, 2012

(HealthDay) -- Continuing use of bevacizumab (Avastin) in combination with second-line chemotherapy improves overall survival (OS) and progression-free survival (PFS) in patients with metastatic colorectal cancer (mCRC) who ...

Recommended for you

New treatment options for a fatal leukemia

July 27, 2015

In industrialized countries like in Europe, acute lymphoblastic leukemia is the most common form of cancer in children. An international research consortium lead by pediatric oncologists from the Universities of Zurich and ...

Modified DNA building blocks are cancer's Achilles heel

July 22, 2015

In studying how cells recycle the building blocks of DNA, Ludwig Cancer Research scientists have discovered a potential therapeutic strategy for cancer. They found that normal cells have highly selective mechanisms to ensure ...

0 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.