Bevacizumab for salvage treatment of metastatic breast cancer

A systemic review and meta-analysis of randomized controlled trials

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15 Citations (Scopus)

Abstract

Summary: Although various new agents have been developed for the treatment of patients with metastatic breast cancer (MBC), overall survival rates have changed little in the last half century. We conducted meta-analysis to verify the clinical efficacy of bevacizumab for the salvage treatment of MBC. Event-based hazard ratios (HR) with 95% confidence intervals (95% CIs) were derived, and a test of heterogeneity was applied. Four studies, with a total of 2,860 patients, met the inclusion criteria for analysis. The pooled results of clinical efficacies were: HR for progression free survival 0.69 (95% CI, 0.58-0.81, z=4.54, P<0.001); HR for overall survival 0.92 (95% CI, 0.82-1.03, z=1.44, P=0.15); and HR for the clinical objective response rate 1.53 (95% CI, 1.37-1.71, z=7.37, P< 0.001). In terms of overall survival, subgroup analysis demonstrated statistically significant improvement for the bevacizumab combination in the initial therapy subgroup (HR, 0.878; 95% CI, 0.771-0.999, z= 1.98, P=0.048). Hypertension and proteinura were more common in the bevacizumab combination arm; however, these toxicities were managed with therapy. In conclusion, meta-analysis suggested benefits of a carefully managed bevacizumab-containing salvage regimen for patients with histologically or cytologically confirmed Her-2 negative MBC who have not received previous cytotoxic therapy. This treatment could improve both progression free survival and overall survival rates.

Original languageEnglish
Pages (from-to)182-188
Number of pages7
JournalInvestigational New Drugs
Volume29
Issue number1
DOIs
Publication statusPublished - 2011 Feb 1

Fingerprint

Salvage Therapy
Meta-Analysis
Randomized Controlled Trials
Confidence Intervals
Breast Neoplasms
Disease-Free Survival
Survival Rate
Therapeutics
Survival Analysis
Bevacizumab
Hypertension
Survival

Keywords

  • Bevacizumab
  • Meta-analysis
  • Metastatic breast cancer
  • Salvage treatment

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Oncology

Cite this

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title = "Bevacizumab for salvage treatment of metastatic breast cancer: A systemic review and meta-analysis of randomized controlled trials",
abstract = "Summary: Although various new agents have been developed for the treatment of patients with metastatic breast cancer (MBC), overall survival rates have changed little in the last half century. We conducted meta-analysis to verify the clinical efficacy of bevacizumab for the salvage treatment of MBC. Event-based hazard ratios (HR) with 95{\%} confidence intervals (95{\%} CIs) were derived, and a test of heterogeneity was applied. Four studies, with a total of 2,860 patients, met the inclusion criteria for analysis. The pooled results of clinical efficacies were: HR for progression free survival 0.69 (95{\%} CI, 0.58-0.81, z=4.54, P<0.001); HR for overall survival 0.92 (95{\%} CI, 0.82-1.03, z=1.44, P=0.15); and HR for the clinical objective response rate 1.53 (95{\%} CI, 1.37-1.71, z=7.37, P< 0.001). In terms of overall survival, subgroup analysis demonstrated statistically significant improvement for the bevacizumab combination in the initial therapy subgroup (HR, 0.878; 95{\%} CI, 0.771-0.999, z= 1.98, P=0.048). Hypertension and proteinura were more common in the bevacizumab combination arm; however, these toxicities were managed with therapy. In conclusion, meta-analysis suggested benefits of a carefully managed bevacizumab-containing salvage regimen for patients with histologically or cytologically confirmed Her-2 negative MBC who have not received previous cytotoxic therapy. This treatment could improve both progression free survival and overall survival rates.",
keywords = "Bevacizumab, Meta-analysis, Metastatic breast cancer, Salvage treatment",
author = "Lee, {Jae Bok} and Woo, {Ok Hee} and Park, {Kyong Hwa} and Woo, {Sang- Uk} and Dae-Sik Yang and Aeree Kim and Lee, {Eun Sook} and Kim, {Yeul Hong} and Kim, {Jun Suk} and Seo, {Jae Hong}",
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T1 - Bevacizumab for salvage treatment of metastatic breast cancer

T2 - A systemic review and meta-analysis of randomized controlled trials

AU - Lee, Jae Bok

AU - Woo, Ok Hee

AU - Park, Kyong Hwa

AU - Woo, Sang- Uk

AU - Yang, Dae-Sik

AU - Kim, Aeree

AU - Lee, Eun Sook

AU - Kim, Yeul Hong

AU - Kim, Jun Suk

AU - Seo, Jae Hong

PY - 2011/2/1

Y1 - 2011/2/1

N2 - Summary: Although various new agents have been developed for the treatment of patients with metastatic breast cancer (MBC), overall survival rates have changed little in the last half century. We conducted meta-analysis to verify the clinical efficacy of bevacizumab for the salvage treatment of MBC. Event-based hazard ratios (HR) with 95% confidence intervals (95% CIs) were derived, and a test of heterogeneity was applied. Four studies, with a total of 2,860 patients, met the inclusion criteria for analysis. The pooled results of clinical efficacies were: HR for progression free survival 0.69 (95% CI, 0.58-0.81, z=4.54, P<0.001); HR for overall survival 0.92 (95% CI, 0.82-1.03, z=1.44, P=0.15); and HR for the clinical objective response rate 1.53 (95% CI, 1.37-1.71, z=7.37, P< 0.001). In terms of overall survival, subgroup analysis demonstrated statistically significant improvement for the bevacizumab combination in the initial therapy subgroup (HR, 0.878; 95% CI, 0.771-0.999, z= 1.98, P=0.048). Hypertension and proteinura were more common in the bevacizumab combination arm; however, these toxicities were managed with therapy. In conclusion, meta-analysis suggested benefits of a carefully managed bevacizumab-containing salvage regimen for patients with histologically or cytologically confirmed Her-2 negative MBC who have not received previous cytotoxic therapy. This treatment could improve both progression free survival and overall survival rates.

AB - Summary: Although various new agents have been developed for the treatment of patients with metastatic breast cancer (MBC), overall survival rates have changed little in the last half century. We conducted meta-analysis to verify the clinical efficacy of bevacizumab for the salvage treatment of MBC. Event-based hazard ratios (HR) with 95% confidence intervals (95% CIs) were derived, and a test of heterogeneity was applied. Four studies, with a total of 2,860 patients, met the inclusion criteria for analysis. The pooled results of clinical efficacies were: HR for progression free survival 0.69 (95% CI, 0.58-0.81, z=4.54, P<0.001); HR for overall survival 0.92 (95% CI, 0.82-1.03, z=1.44, P=0.15); and HR for the clinical objective response rate 1.53 (95% CI, 1.37-1.71, z=7.37, P< 0.001). In terms of overall survival, subgroup analysis demonstrated statistically significant improvement for the bevacizumab combination in the initial therapy subgroup (HR, 0.878; 95% CI, 0.771-0.999, z= 1.98, P=0.048). Hypertension and proteinura were more common in the bevacizumab combination arm; however, these toxicities were managed with therapy. In conclusion, meta-analysis suggested benefits of a carefully managed bevacizumab-containing salvage regimen for patients with histologically or cytologically confirmed Her-2 negative MBC who have not received previous cytotoxic therapy. This treatment could improve both progression free survival and overall survival rates.

KW - Bevacizumab

KW - Meta-analysis

KW - Metastatic breast cancer

KW - Salvage treatment

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