title: First-line bevacizumab-containing therapy for breast cancer: results in patients aged≥70 years treated in the ATHENA study.
abstract: BACKGROUND
  There are limited data on treatment outcomes in the growing population of elderly patients with locally recurrent/metastatic breast cancer (LR/mBC). To gain information on first-line bevacizumab combined with chemotherapy in the elderly, we analyzed data from the ATHENA trial in routine oncology practice.
  
  
  METHODS
  Patients with human epidermal growth factor receptor-2-negative LR/mBC received first-line bevacizumab with standard chemotherapy until disease progression, unacceptable toxicity, or physician/patient decision. We carried out a subgroup analysis of safety and efficacy in patients aged≥70 years. Possible correlations between tolerability and baseline comorbidities or Eastern Cooperative Oncology Group status were explored.
  
  
  RESULTS
  Bevacizumab was combined with single-agent paclitaxel in 46% of older patients. Only hypertension and proteinuria were more common in older than in younger patients (grade≥3 hypertension: 6.9% versus 4.2%, respectively; grade≥3 proteinuria: 4.0% versus 1.5%, respectively). Grade≥3 arterial/venous thromboembolism occurred in 2.9% versus 3.3%, respectively. Further analysis revealed no relationship between baseline presence and severity of hypertension and risk of developing hypertension during bevacizumab-containing therapy. Median time to progression was 10.4 months in patients aged≥70 years.
  
  
  CONCLUSIONS
  These findings suggest that bevacizumab-containing therapy is tolerable and active in patients aged≥70 years. Hypertension was more common than in younger patients but was manageable. We find no evidence precluding the use of bevacizumab in older patients, including those with hypertension, although age may influence chemotherapy choice.
authors: 'Sandro Pitigliani' Medical Oncology Unit, Prato Hospital, Istituto Toscano Tumori, Prato. Electronic address: lbiganzoli@usl4.toscana.it.
authors: L
authors: L
authors: Biganzoli
authors: Cardiologic Unit, Prato Hospital, Prato, Italy.
authors: E
authors: E
authors: Di Vincenzo
authors: Department of Breast Cancer, Beijing 307 Hospital, Beijing, China.
authors: Z
authors: Z
authors: Jiang
authors: Department of Combined Modality Treatment and Chemotherapy of Malignant Tumors, N. N. Blokhin Russian Oncology Research Center, Moscow, Russia.
authors: M
authors: M
authors: Lichinitser
authors: Department of Breast Surgery, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
authors: Z
authors: Z
authors: Shen
authors: Paul Papin Centre, Angers, France.
authors: R
authors: R
authors: Delva
authors: State Institution P.A. Herzen Moscow, Cancer Research Institute, Moscow, Russia.
authors: N
authors: N
authors: Bogdanova
authors: Medical Oncology Department, Cruces Hospital, Barakaldo, Spain.
authors: G L
authors: GL
authors: Vivanco
authors: Department of Medical Oncology, First Affiliated Hospital of Anhui Medical University, He Fei.
authors: Z
authors: Z
authors: Chen
authors: Department of Internal Medicine, Jilin Cancer Hospital, Changchun, China.
authors: Y
authors: Y
authors: Cheng
authors: Internal Medicine Practice, Bielefeld, Germany.
authors: M
authors: M
authors: Just
authors: Breast Disease Centre, Hôpital Saint Louis, Paris, France.
authors: M
authors: M
authors: Espié
authors: Oncology Clinic, Porto Alegre, Brazil.
authors: J
authors: J
authors: Vinholes
authors: Department of Oncology, University of Western Ontario, Windsor, Canada.
authors: C
authors: C
authors: Hamm
authors: Division of Medical Oncology, National Cancer Institute, Centro di Riferimento Oncologico, Aviano, Italy.
authors: D
authors: D
authors: Crivellari
authors: Department of Clinical Oncology, Bydgoszcz Oncology Centre, Bydgoszcz, Poland.
authors: E
authors: E
authors: Chmielowska
authors: Breast Cancer Department, N. N. Petrov Research Institute of Oncology, St Petersburg, Russia.
authors: V
authors: V
authors: Semiglazov
authors: Department of Medical Oncology, Claudius Regaud Institute, Toulouse, France.
authors: F
authors: F
authors: Dalenc
authors: Breast Unit, Royal Marsden Hospital and Institute of Cancer Research, London, UK.
authors: I
authors: I
authors: Smith
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage* / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D000068258:Bevacizumab; D001943:Breast Neoplasms / Q000188:drug therapy*; D000069287:Capecitabine; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D000077143:Docetaxel; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D006801:Humans; D006973:Hypertension / Q000139:chemically induced / Q000453:epidemiology; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects; D014747:Vinblastine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D000077235:Vinorelbine
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D043823:Taxoids; D003841:Deoxycytidine; D000077143:Docetaxel; D000068258:Bevacizumab; D014747:Vinblastine; D000069287:Capecitabine; D017239:Paclitaxel; D000077235:Vinorelbine; D005472:Fluorouracil