Elsevier

Annals of Oncology

Volume 24, Issue 12, December 2013, Pages 2978-2984
Annals of Oncology

original articles
breast cancer
Neoadjuvant bevacizumab and anthracycline–taxane-based chemotherapy in 678 triple-negative primary breast cancers; results from the geparquinto study (GBG 44)

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Abstract

Background

We evaluated the pathological complete response (pCR) rate after neoadjuvant epirubicin, (E) cyclophosphamide (C) and docetaxel containing chemotherapy with and without the addition of bevacizumab in patients with triple-negative breast cancer (TNBC).

Patients and methods

Patients with untreated cT1c-4d TNBC represented a stratified subset of the 1948 participants of the HER2-negative part of the GeparQuinto trial. Patients were randomized to receive four cycles EC (90/600 mg/m2; q3w) followed by four cycles docetaxel (100 mg/m2; q3w) each with or without bevacizumab (15 mg/kg; q3w) added to chemotherapy.

Results

TNBC patients were randomized to chemotherapy without (n = 340) or with bevacizumab (n = 323). pCR (ypT0 ypN0, primary end point) rates were 27.9% without and 39.3% with bevacizumab (P = 0.003). According to other pCR definitions, the addition of bevacizumab increased the pCR rate from 30.9% to 41.8% (ypT0 ypN0/+; P = 0.004), 36.2% to 46.4% (ypT0/is ypN0/+; P = 0.009) and 32.9% to 43.3% (ypT0/is ypN0; P = 0.007). Bevacizumab treatment [OR 1.73, 95% confidence interval (CI) 1.23–2.42; P = 0.002], lower tumor stage (OR 2.38, 95% CI 1.24–4.54; P = 0.009) and grade 3 tumors (OR 1.68, 95% CI 1.14–2.48; P = 0.009) were confirmed as independent predictors of higher pCR in multivariate logistic regression analysis.

Conclusions

The addition of bevacizumab to chemotherapy in TNBC significantly increases pCR rates.

Keywords

triple-negative breast cancer
bevacizumab
neoadjuvant chemotherapy
pathological response rate

Cited by (0)

The study was previously presented as an oral presentation at the 33rd Annual Meeting of the American Society of Clinical Oncology; 3–5 June 2011; Chicago, IL, USA.