含贝伐的晚期乳腺癌一线治疗:有效率57%,完全缓解率23%
  • 本研究的目的是描述Bevacizumab和化疗在临床上对治疗MBC的临床特征、预后因素和安全性;
  • 148例符合条件的患者:转移性或局部晚期乳腺癌妇女,采用bevacizumab作为一线治疗药,无进展生存期≥12个月;
  • 多数患者有客观反应,23%完全缓解,57%部分缓解,58.2个月中位OS,22.7个月中位PFS;
  • 激素维持治疗(a,HMT)和转移诊断前未接受紫杉烷类治疗(b)的患者OS更高(a,b为OS的两独立预后因素),HMT患者的PFS更高(a是PFS的预后因素);
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Long-term responders to first-line bevacizumab-based therapy in metastatic breast cancer (MBC) patients: Results of the observational study LORENA

LORENA观察性研究结果:以贝伐单抗(bevacizumab)为一线治疗药MBC患者的长期反应

2017-06-03

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Background: Randomized controlled trials in MBC patients evaluating bevacizumab as first-line treatment showed improvements in tumor response and progression-free survival (PFS) when added to chemotherapy. The aim of the LORENA study was to describe the clinical features, prognosis factors and safety of bevacizumab and chemotherapy treatment for MBC in routine practice.
Methods: Observational, multicentre, ambispective study conducted in Spain. The study had a retrospective and a prospective phase. Data were obtained from March 2012 to October 2013. In the retrospective phase, eligible patients were women with metastatic or locally-advanced breast cancer, treated with bevacizumab as a first-line therapy, and progression-free survival for ≥ 12 months. In the prospective phase, patients were followed-up and assessed as per routine clinical practice. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan-Meier method. Univariate and multivariate analyses of prognostic factors were performed.
Results: 148 women from 38 centers were included. The mean age was 52 (±11) years. Bone, lung and liver were the most frequent metastasis sites. 138 patients were HER2-neg. on diagnosis (data unknown in 10 patients). The mean exposure to bevacizumab was 18 (±11) months. Most patients had objective response, 23% complete response, and 57% partial response. Median OS was 58.2 months and median PFS was 22.7 months. In multivariate analyses, OS was higher in patients with hormonal maintenance therapy (HMT) (p = 0.009; HR = 2.0) and in patients not treated with taxanes before the metastatic diagnosis (p < 0.0001; HR = 3.3); also, PFS was higher in patients with HMT (p = 0.002; HR = 1.8). No adverse events were observed other than those reported previously.
Conclusions: Outcomes of OS and PFS suggest a benefit from bevacizumab maintained therapy. HMT was a PFS prognosis factor. HMT and not having been treated with taxanes before the metastatic diagnosis were two independent OS prognosis factors. Our results could provide further evidence supporting the use of bevacizumab as maintenance therapy for MBC patients.

All Authors:
Manuel Ramos Vazquez

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