title: Neoadjuvant bevacizumab and anthracycline-taxane-based chemotherapy in 678 triple-negative primary breast cancers; results from the geparquinto study (GBG 44).
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).
  
  
  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/m(2); q3w) followed by four cycles docetaxel (100 mg/m(2); 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.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Rostock, Rostock.
authors.forename: B
authors.initials: B
authors.lastname: Gerber
authors.forename: S
authors.initials: S
authors.lastname: Loibl
authors.forename: H
authors.initials: H
authors.lastname: Eidtmann
authors.forename: M
authors.initials: M
authors.lastname: Rezai
authors.forename: P A
authors.initials: PA
authors.lastname: Fasching
authors.forename: H
authors.initials: H
authors.lastname: Tesch
authors.forename: H
authors.initials: H
authors.lastname: Eggemann
authors.forename: I
authors.initials: I
authors.lastname: Schrader
authors.forename: K
authors.initials: K
authors.lastname: Kittel
authors.forename: C
authors.initials: C
authors.lastname: Hanusch
authors.forename: R
authors.initials: R
authors.lastname: Kreienberg
authors.forename: C
authors.initials: C
authors.lastname: Solbach
authors.forename: C
authors.initials: C
authors.lastname: Jackisch
authors.forename: G
authors.initials: G
authors.lastname: Kunz
authors.forename: J U
authors.initials: JU
authors.lastname: Blohmer
authors.forename: J
authors.initials: J
authors.lastname: Huober
authors.forename: M
authors.initials: M
authors.lastname: Hauschild
authors.forename: V
authors.initials: V
authors.lastname: Nekljudova
authors.forename: M
authors.initials: M
authors.lastname: Untch
authors.forename: G
authors.initials: G
authors.lastname: von Minckwitz
mesh_terms: D000328:Adult; D000368:Aged; D018943:Anthracyclines / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D003520:Cyclophosphamide / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D000068338:Everolimus; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D020360:Neoadjuvant Therapy; D017239:Paclitaxel / Q000008:administration & dosage; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives; D016896:Treatment Outcome; D064726:Triple Negative Breast Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D047368:Tumor Burden / Q000187:drug effects; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D018943:Anthracyclines; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D015251:Epirubicin; D003520:Cyclophosphamide; D000068338:Everolimus; D017239:Paclitaxel; D020123:Sirolimus
keywords: bevacizumab; neoadjuvant chemotherapy; pathological response rate; triple-negative breast cancer