title: Factors Associated with the Selection of First-line Bevacizumab plus Chemotherapy and Clinical Response in HER2-negative Metastatic Breast Cancer: ONCOSUR AVALOX Study.
abstract: OBJECTIVE
  To evaluate factors associated with the selection of first-line bevacizumab plus chemotherapy and clinical response in HER2-negative metastatic breast cancer (MBC) in clinical practice in Spain.
  
  
  METHODS
  All consecutive adult female patients with HER2-negative MBC who had received first-line bevacizumab plus chemotherapy for at least 3 months were enrolled in the present study.
  
  
  RESULTS
  A total of 292 evaluable patients were included; 25% had triple-negative breast cancer (TNBC) and 75% had hormone receptor-positive breast cancer (HRPBC). Nearly 40% of patients had ≥3 metastatic sites, mainly located in the bone (48%) and liver (40%). Bevacizumab was mostly combined with paclitaxel (67.1%). ER-positive tumors were only identified as an independent factor associated with the choice of treatment (odds ratio (OR): 0.538; p=0.02). The overall response rate (ORR) was 63.7% (TNBC: 57.5%; HRPBC: 65.9%). Patients aged 36-50 years (OR: 3.03; p=0.028) and those with metastases at sites other than the bone (OR: 0.38; p=0.001) and ≥3 metastatic sites (OR: 1.41; p=0.018) were more likely to achieve objective responses.
  
  
  CONCLUSIONS
  First-line bevacizumab plus chemotherapy, mainly paclitaxel, is an effective and well-tolerated treatment option for HER2-negative MBC, particularly in more aggressive disease.
authors.affiliation: Hospital 12 de Octubre, ONCOSUR, Madrid, Spain lmanso@salud.madrid.org.
authors.forename: Luís
authors.initials: L
authors.lastname: Manso
authors.affiliation: Hospital de León, León, Spain.
authors.forename: Andrés García
authors.initials: AG
authors.lastname: Palomo
authors.affiliation: Clínica Quirón Madrid, Madrid, Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: Pérez Carrión
authors.affiliation: Hospital de Guadalajara, ONCOSUR, Guadalajara, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Cassinello
authors.affiliation: Hospital General de Segovia, ONCOSUR, Segovia, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Gallegos Sancho
authors.affiliation: Hospital Virgen de la Salud, ONCOSUR, Toledo, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Chacón López-Muñiz
authors.affiliation: Hospital de Alcorcón, ONCOSUR, Madrid, Spain.
authors.forename: Clara
authors.initials: C
authors.lastname: Olier
authors.affiliation: Complejo Hospitalario Universitario de Albacete, Albacete, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Fernández-Aramburo
authors.affiliation: Hospital de Elda, Alicante, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Llorca
authors.affiliation: Hospital Clinic i Provincial, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: González
authors.affiliation: Hospital Dr. Peset, Valencia, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Llorente
authors.affiliation: Hospital de Luis Alcanyis, Xátiva, Valencia, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Torregrosa
authors.affiliation: Hospital General San Jorge, Huesca, Spain.
authors.forename: Iñaki
authors.initials: I
authors.lastname: Álvarez
authors.affiliation: Hospital de Basurto, Vizcaya, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Gálve
authors.affiliation: Hospital Infanta Cristina, ONCOSUR, Madrid, Spain.
authors.forename: Coralia
authors.initials: C
authors.lastname: Bueno
authors.affiliation: Hospital Son Llatzer, Palma de Mallorca, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Garau
authors.affiliation: Hospital General de Ciudad Real, ONCOSUR, Ciudad Real, Spain.
authors.forename: María José
authors.initials: MJ
authors.lastname: García
authors.affiliation: Hospital San Pedro de Alcántara, ONCOSUR, Cáceres, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: González-Santiago
authors.affiliation: Hospital Universitario La Princesa, Madrid, Spain.
authors.forename: Ana Isabel
authors.initials: AI
authors.lastname: Ballesteros
authors.affiliation: Hospital Infanta Cristina, ONCOSUR, Badajoz, Spain.
authors.forename: Esperanza
authors.initials: E
authors.lastname: Blanco
authors.affiliation: Hospital de Sagunto, Valencia, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Galán
authors.affiliation: Hospital Mutua de Terrassa, Barcelona, Spain.
authors.forename: Sonia
authors.initials: S
authors.lastname: González
authors.affiliation: Hospital Son Dureta, Palma de Mallorca, Spain.
authors.forename: Antonia
authors.initials: A
authors.lastname: Perelló
authors.affiliation: Hospital 12 de Octubre, ONCOSUR, Madrid, Spain.
authors.forename: Hernán
authors.initials: H
authors.lastname: Cortés-Funes
authors.affiliation: Hospital 12 de Octubre, ONCOSUR, Madrid, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Grávalos
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D009362:Neoplasm Metastasis; D017239:Paclitaxel / Q000008:administration & dosage; D011788:Quality of Life; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D064726:Triple Negative Breast Neoplasms / Q000188:drug therapy / Q000473:pathology
chemical_list: D000068258:Bevacizumab; D017239:Paclitaxel; D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human
keywords: Bevacizumab; breast cancer; epidermal growth factor receptor (HER2)-negative; metastatic disease; predictive factors