Bevacizumab plus preoperative chemotherapy in operable HER2 negative breast cancer: biomarkers and pathologic response

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2013Author
Sánchez Rovira, Pedro
Seguí, M. A.
Llombart, A.
Aranda, Enrique
Antón, Antonio
Sánchez, A.
Lomas, M.
Jaén, A.
Fernández, M.
Porras, I.
Dalmau, E.
Morales Murillo, Serafín
Haba-Rodríguez, J. de la
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Sánchez Rovira, Pedro;
Seguí, M. A.;
Llombart, A.;
Aranda, Enrique;
Antón, Antonio;
Sánchez, A.;
...
Haba-Rodríguez, J. de la.
(2013)
.
Bevacizumab plus preoperative chemotherapy in operable HER2 negative breast cancer: biomarkers and pathologic response.
Clinical & Translational Oncology, 2013, vol. 15, núm. 10, p. 810-817.
https://doi.org/10.1007/s12094-013-1006-4.
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Purpose: The primary aim of this trial was to assess the rate of pathologic complete responses (pCR) of doxorubicin/cyclophosphamide (AC) followed by bevacizumab/docetaxel (BT), as neoadjuvant therapy for breast cancer (BC). Furthermore, the association between biomarkers and the pCR was explored.
Methods: Patients with HER-negative operable stage II–III BC ≥2 cm were enrolled. Four cycles of AC (A 60 mg/m2 and C 600 mg/m2, every 3 weeks) followed by 4 cycles of BT (B 15 mg/kg and T 75 mg/m2, every 3 weeks), were planned. A core-biopsy was performed for biological markers assessment.
Results: Seventy-two women were included. Forty-three (63 %) patients were hormone receptor-positive. Sixty-four (89 %) completed the planned treatment, and 66 evaluable patients underwent surgery (92 %): a pCR was achieved in 16 of them (24, 95 % CI 15–36 %). pCR was significantly higher in tumors hormone receptor-negative, and in those with Angiotensin II type 1 receptor (AGTR1) protein overexpression. The overall clinical response rate was 86 % (95 % CI 76–93 %), including 42 complete responses. No unexpected toxicities or treatment-related deaths were observed.
Conclusion: This regimen showed a remarkable clinical and pathological activity: the suggested relation between pCR and AGTR1 overexpression should be confirmed in larger trials.
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