title: Bevacizumab Addition in Neoadjuvant Treatment Increases the Pathological Complete Response Rates in Patients with HER-2 Negative Breast Cancer Especially Triple Negative Breast Cancer: A Meta-Analysis.
abstract: BACKGROUND
  Neoadjuvant therapy is administered to breast cancer patients as an induction process before surgery or radiotherapy to reduce tumor size. Human epidermal growth factor receptor-2 (HER-2) negative breast cancer lacks effective standard target therapy. Bevacizumab has a controversial role in the treatment of breast cancer and we conduct a meta-analysis to evaluate the value of adding bevacizumab in neoadjuvant regimen.
  
  
  METHODS
  Potentially eligible studies were retrieved using PubMed, EMBASE and Medline. Clinical characteristics of patients and statistical data with pathological complete response (pCR) data were collected. Then a meta-analysis model was established to investigate the correlation between administration of bevacizumab in neoadjuvant therapy and pCR rates in HER-2 negative breast cancer.
  
  
  RESULTS
  Seven eligible studies and 5408 patients were yielded. The pCR rates for "breast" or "breast plus lymph node" were similar. In subgroup analysis, we emphasized on patients with triple-negative breast cancer (TNBC). In the criterion of "lesions in breast" the pooled ORs was 1.55 [1.29, 1.86], P<0.00001 and regarding to the evaluation criterion of "lesions in breast and lymph nodes", the pooled ORs was 1.48 [1.23, 1.78], P<0.0001, in favor of bevacizumab administration.
  
  
  CONCLUSIONS
  According to our pooled results, we finally find that bevacizumab addition as a neoadjuvant chemotherapy component, for induction use with limited cycle to improve the pCR rates and patients may avoid long-term adverse event and long-term invalid survival improvement. Especially in subgroup analysis, pCR rates could be improved significantly and physicians could consider bevacizumab with caution. As patients could avoid the adverse event caused by long-term using of bevacizumab, long-term quality of life improvement may be achieved, especially in TNBC.
authors: State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, China.
authors: Xuelei
authors: X
authors: Ma
authors: Department of Clinical Oncology, Sichuan Provincial People's Hospital, Chengdu, Sichuan, China.
authors: Xiaoshan
authors: X
authors: Wang
authors: Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors: Jingwen
authors: J
authors: Huang
authors: Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical Collage, Beijing, China.
authors: Yingtai
authors: Y
authors: Chen
authors: Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors: Jing
authors: J
authors: Zhang
authors: State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, China.
authors: Binglan
authors: B
authors: Zhang
authors: Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors: Changle
authors: C
authors: Shi
authors: Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors: Lei
authors: L
authors: Liu
mesh_terms: D000068258:Bevacizumab / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000378:metabolism / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D020360:Neoadjuvant Therapy / Q000379:methods*; D018719:Erb-b2 Receptor Tyrosine Kinases
chemical_list: D000068258:Bevacizumab; D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human