Elsevier

Clinical Breast Cancer

Volume 7, Issue 10, October 2007, Pages 779-783
Clinical Breast Cancer

Original Contribution
Bevacizumab and Albumin-Bound Paclitaxel Treatment in Metastatic Breast Cancer

https://doi.org/10.3816/CBC.2007.n.039Get rights and content

Abstract

Background

Miller et al demonstrated that the combination of bevacizumab and paclitaxel has significant activity in metastatic breast cancer (MBC). Because albumin-bound paclitaxel has been shown to have less toxicity, a better tumor delivery, and possibly better response for MBC, we combined it with bevacizumab to treat women with MBC.

Patients and Methods

This is a retrospective analysis. Billing records from March 2005 through December 2006 were reviewed to identify all patients treated with a combination of albumin-bound paclitaxel/bevacizumab. A total of 40 women were identified. They received a minimum of 2 courses. Patients with measurable disease were monitored for response using Response Evaluation Criteria in Solid Tumors. Women with bone-only disease were monitored with positron emission tomography (PET)/computed tomography/magnetic resonance imaging and tumor markers. All response data were confirmed by independent review.

Results

Of 33 women with measurable disease, 16 had objective responses to the albumin-bound paclitaxel/bevacizumab regimen (3 complete responses and 13 partial responses) for an overall response rate (ORR) of 48.5%. Median time to progression for responders was 128 days. Another 5 women had stable disease (SD) with a median duration of 135 days. Of 7 patients with bone-only disease, 2 had almost complete resolution of PET activity and 4 had SD (median, 148 days). Toxicity was acceptable with fatigue, neuropathy, pain, and hypertension being the most common complaints.

Conclusion

In our limited series of women with advanced, heavily pretreated MBC treated with albumin-bound paclitaxel/bevacizumab, we saw a 48.5% ORR. The regimen was well tolerated. Randomized studies are needed to confirm efficacy and safety of this combination in treating breast cancer.

References (21)

  • KD Miller et al.

    Breast cancer: the role of angiogenesis and antiangiogenic therapy

    Hematol Oncol Clin N Am

    (2004)
  • MA Cobleigh et al.

    A phase I/II dose escalation trial of bevacizumab in previously treated metastatic breast cancer

    Semin Oncol

    (2003)
  • American Cancer Society

    Cancer Facts & Figures 2007

    (2007)
  • KA Cronin et al.

    Impact of adjuvant therapy and mammography on U.S. mortality from 1975 to 2000: comparison of mortality results from the CISNET breast cancer base case analysis

    J Natl Cancer Inst Monogr

    (2006)
  • KD Miller

    Recent translational research: antiangiogenic therapy for breast cancer-where do we stand?

    Breast Cancer Res

    (2004)
  • VEGF Overview

    Genentech Web site

  • KD Miller et al.

    Phase III trial of capecitabine (Xeloda) plus bevacizumab (Avastin) versus capecitabine alone in women with metastatic breast cancer previously treated with an anthracycline and a taxane

    Breast Cancer Res Treat

    (2002)
  • Update on phase III ECOG E2100 trial: paclitaxel/bevacizumab in metastatic breast cancer

    Cancer Abstracts and Summaries

    (2006)
  • NK Ibrahim et al.

    Multicenter phase II trial of ABI-007, an albumin-bound paclitaxel, in women with metastatic breast cancer

    J Clin Oncol

    (2005)
  • WJ Gradishar et al.

    Phase III trial of nanoparticle albumin-bound paclitaxel compared with polyethylated castor oil-based paclitaxel in women with breast cancer

    J Clin Oncol

    (2005)
There are more references available in the full text version of this article.

Cited by (30)

  • Tailoring the dosing schedule of nab-paclitaxel in metastatic breast cancer according to patient and disease characteristics: Recommendations from a panel of experts

    2016, Critical Reviews in Oncology/Hematology
    Citation Excerpt :

    In these studies, the ORR ranged from 36% (Link et al., 2007) to 76% (Lobo et al., 2010). Although a Q2W dosing schedule of nab-paclitaxel appeared to have an acceptable toxicity profile at doses up to 200 mg/m2 (Link et al., 2007; Lobo et al., 2010), treatment with nab-paclitaxel 260 mg/m2 Q2W in combination with bevacizumab (with filgrastim) given as first line therapy in 54 patients with human epidermal growth factor receptor-2 (HER2)-negative MBC resulted in unacceptable toxicity (grade ≥2 fatigue: 62%, bone pain: 23%) and led to the premature closure of that particular arm of the trial (Seidman et al., 2013). The feasibility of QW dosing of nab-paclitaxel was demonstrated in a phase I study of 39 patients with advanced non-haematological malignancies who received nab-paclitaxel 80–200 mg/m2 QW 3/4, with dose escalation according to a standard 3 + 3 design (Nyman et al., 2005).

  • Phase 1-2 study of docetaxel plus aflibercept in patients with recurrent ovarian, primary peritoneal, or fallopian tube cancer

    2011, The Lancet Oncology
    Citation Excerpt :

    We previously reported that aflibercept was effective in preclinical models of ovarian cancer and had additive, and in some models, synergistic activity with taxanes.1,21,22 These data corroborate other results that have convincingly showed that taxanes, regardless of schedule, and anti-VEGF therapy have synergistic activity in various solid tumours.23–31 At clinically relevant doses, docetaxel produces serum concentrations that are associated with in-vitro tumour-cell apoptosis and antiangiogenic properties, such as endothelial-cell proliferation, migration, and capillary-tube formation.32,33

  • Management of breast cancer with nanoparticle albumin-bound (nab)-paclitaxel combination regimens: A clinical review

    2011, Breast
    Citation Excerpt :

    While bevacizumab improved PFS in both studies, data for individual regimens remain unpublished. Within a cohort of 40 patients (85% treated previously for MBC), Link et al.17 retrospectively assessed outcomes following nab-paclitaxel (either 80–125 mg/m2 d1,8,15 q28d or 170–220 mg/m2 d1,15 q28d) + bevacizumab (10 mg/kg d1 q14d). Of 33 evaluable patients, 30% were HER2-positive and had progressed on trastuzumab; many HER2-positive individuals continued to receive trastuzumab during nab-paclitaxel + bevacizumab therapy.

View all citing articles on Scopus

Electronic forwarding or copying is a violation of US and International Copyright Laws.

Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by CIG Media Group, LP, ISSN #1526-8209, provided the appropriate fee is paid directly to Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923 USA 978-750-8400.

View full text