Paclitaxel plus bevacizumab versus paclitaxel alone for metastatic breast cancer
- PMID: 18160686
- DOI: 10.1056/NEJMoa072113
Paclitaxel plus bevacizumab versus paclitaxel alone for metastatic breast cancer
Abstract
Background: In an open-label, randomized, phase 3 trial, we compared the efficacy and safety of paclitaxel with that of paclitaxel plus bevacizumab, a monoclonal antibody against vascular endothelial growth factor, as initial treatment for metastatic breast cancer.
Methods: We randomly assigned patients to receive 90 mg of paclitaxel per square meter of body-surface area on days 1, 8, and 15 every 4 weeks, either alone or with 10 mg of bevacizumab per kilogram of body weight on days 1 and 15. The primary end point was progression-free survival; overall survival was a secondary end point.
Results: From December 2001 through May 2004, a total of 722 patients were enrolled. Paclitaxel plus bevacizumab significantly prolonged progression-free survival as compared with paclitaxel alone (median, 11.8 vs. 5.9 months; hazard ratio for progression, 0.60; P<0.001) and increased the objective response rate (36.9% vs. 21.2%, P<0.001). The overall survival rate, however, was similar in the two groups (median, 26.7 vs. 25.2 months; hazard ratio, 0.88; P=0.16). Grade 3 or 4 hypertension (14.8% vs. 0.0%, P<0.001), proteinuria (3.6% vs. 0.0%, P<0.001), headache (2.2% vs. 0.0%, P=0.008), and cerebrovascular ischemia (1.9% vs. 0.0%, P=0.02) were more frequent in patients receiving paclitaxel plus bevacizumab. Infection was more common in patients receiving paclitaxel plus bevacizumab (9.3% vs. 2.9%, P<0.001), but febrile neutropenia was uncommon (<1% overall).
Conclusions: Initial therapy of metastatic breast cancer with paclitaxel plus bevacizumab prolongs progression-free survival, but not overall survival, as compared with paclitaxel alone. (ClinicalTrials.gov number, NCT00028990 [ClinicalTrials.gov].).
Copyright 2007 Massachusetts Medical Society.
Comment in
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Paclitaxel plus bevacizumab for metastatic breast cancer.N Engl J Med. 2008 Apr 10;358(15):1637; author reply 1637-8. doi: 10.1056/NEJMc080128. N Engl J Med. 2008. PMID: 18403775 No abstract available.
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Paclitaxel plus bevacizumab for metastatic breast cancer.N Engl J Med. 2008 Apr 10;358(15):1637; author reply 1637-8. N Engl J Med. 2008. PMID: 18411431 No abstract available.
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Adding bevacizumab to paclitaxel in the first-line treatment of metastatic breast cancer.Curr Oncol Rep. 2009 Jan;11(1):5-6. Curr Oncol Rep. 2009. PMID: 19080734 No abstract available.
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