TY - JOUR
T1 - A feasibility study of bevacizumab plus dose-dense doxorubicin- cyclophosphamide (AC) followed by nanoparticle albumin-bound paclitaxel in early-stage breast cancer
AU - McArthur, Heather L.
AU - Rugo, Hope
AU - Nulsen, Benjamin
AU - Hawks, Laura
AU - Grothusen, Jill
AU - Melisko, Michelle
AU - Moasser, Mark
AU - Paulson, Matthew
AU - Traina, Tiffany
AU - Patil, Sujata
AU - Zhou, Qin
AU - Steingart, Richard
AU - Dang, Chau
AU - Morrow, Monica
AU - Cordeiro, Peter
AU - Fornier, Monica
AU - Park, John
AU - Seidman, Andrew
AU - Lake, Diana
AU - Gilewski, Theresa
AU - Theodoulou, Maria
AU - Modi, Shanu
AU - D'Andrea, Gabriella
AU - Sklarin, Nancy
AU - Robson, Mark
AU - Moynahan, Mary Ellen
AU - Sugarman, Steven
AU - Sealey, Jane E.
AU - Laragh, John H.
AU - Merali, Carmen
AU - Norton, Larry
AU - Hudis, Clifford A.
AU - Dickler, Maura N.
PY - 2011/5/15
Y1 - 2011/5/15
N2 - Purpose: Bevacizumab confers benefits in metastatic breast cancer but may be more effective as adjuvant therapy. We evaluated the cardiac safety of bevacizumab plus dose-dense doxorubicin-cyclophosphamide (ddAC) → nanoparticle albumin-bound (nab)-paclitaxel in human epidermal growth factor receptor 2 normal early-stage breast cancer. Experimental Design: Eighty patients with normal left ventricular ejection fraction (LVEF) were enrolled. Bevacizumab was administered for 1 year, concurrently with ddAC → nab-paclitaxel then as a single agent. LVEF was evaluated at months 0, 2, 6, 9, and 18. This regimen was considered safe if fewer than three cardiac events or fewer than two deaths from left ventricular dysfunction occurred. Correlative studies of cardiac troponin (cTn) and plasma renin activity (PRA) were conducted. Results: The median age was 48 years (range, 27-75 years), and baseline LVEF was 68% (53%-82%). After 39 months' median follow-up (5-45 months): median LVEF was 68% (53%-80%) at 2 months (n = 78), 64% (51%-77%) at 6 months (n=66), 63% (48%-77%) at 9 months (n=61), and 66% (42%-76%) at 18 months (n = 54). One patient developed symptomatic LV dysfunction at month 15. Common toxicities necessitating treatment discontinuation were hypertension (HTN, 4%), wound-healing complications (4%), and asymptomatic LVEF declines (4%). Neither cTn nor PRA predicted congestive heart failure (CHF) or HTN, respectively. Conclusions: Bevacizumab with ddAC → nab-paclitaxel had a low rate of cardiac events; cTn and PRA levels are not predictive of CHF or HTN, respectively. The efficacy of bevacizumab as adjuvant treatment will be established in several ongoing phase III trials.
AB - Purpose: Bevacizumab confers benefits in metastatic breast cancer but may be more effective as adjuvant therapy. We evaluated the cardiac safety of bevacizumab plus dose-dense doxorubicin-cyclophosphamide (ddAC) → nanoparticle albumin-bound (nab)-paclitaxel in human epidermal growth factor receptor 2 normal early-stage breast cancer. Experimental Design: Eighty patients with normal left ventricular ejection fraction (LVEF) were enrolled. Bevacizumab was administered for 1 year, concurrently with ddAC → nab-paclitaxel then as a single agent. LVEF was evaluated at months 0, 2, 6, 9, and 18. This regimen was considered safe if fewer than three cardiac events or fewer than two deaths from left ventricular dysfunction occurred. Correlative studies of cardiac troponin (cTn) and plasma renin activity (PRA) were conducted. Results: The median age was 48 years (range, 27-75 years), and baseline LVEF was 68% (53%-82%). After 39 months' median follow-up (5-45 months): median LVEF was 68% (53%-80%) at 2 months (n = 78), 64% (51%-77%) at 6 months (n=66), 63% (48%-77%) at 9 months (n=61), and 66% (42%-76%) at 18 months (n = 54). One patient developed symptomatic LV dysfunction at month 15. Common toxicities necessitating treatment discontinuation were hypertension (HTN, 4%), wound-healing complications (4%), and asymptomatic LVEF declines (4%). Neither cTn nor PRA predicted congestive heart failure (CHF) or HTN, respectively. Conclusions: Bevacizumab with ddAC → nab-paclitaxel had a low rate of cardiac events; cTn and PRA levels are not predictive of CHF or HTN, respectively. The efficacy of bevacizumab as adjuvant treatment will be established in several ongoing phase III trials.
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U2 - 10.1158/1078-0432.CCR-10-1969
DO - 10.1158/1078-0432.CCR-10-1969
M3 - Article
C2 - 21350003
AN - SCOPUS:79956019675
SN - 1078-0432
VL - 17
SP - 3398
EP - 3407
JO - Clinical Cancer Research
JF - Clinical Cancer Research
IS - 10
ER -