Salvage therapy of pretreated advanced breast cancer with bevacizumab and paclitaxel every two weeks: a retrospective case review study

Patients with pretreated ABC and progressive disease received BEV 10 mg/kg with PAC 135 mg/m2 every two weeks for six months and then maintenance with BEV 15 mg/kg every three weeks until progression. This regimen was chosen for better patient convenience, while maintaining the same dose intensity for both drugs.42 patients were reviewed retrospectively (41 f, 1 m, mean age 57 years). Overall response rate was 35.7%. Stable disease was observed in 45.2% of patients, whereas 14.3% of patients progressed. The median overall survival was greater than 20 months, with a one year rate of 83.4%. The median progression free survival was 12.1 months, with a one year rate of 51.8%. Toxicity was in general acceptable.This biweekly BEV/PAC combination seems to be active with acceptable toxicity in pretreated ABC with an advantage over the weekly regimen regarding quality of life and preservation of resources.Cancer is a major public health problem in most parts of the world. It is estimated that about 565,650 Americans died from cancer in 2008 and among these deaths, 40,480 were due to breast cancer in women. The new breast cancer cases among American women for 2008 were 182,460 [1].Despite adjuvant chemotherapy, approximately 40--50% of patients will develop recurrent and/or metastatic breast cancer with angiogenesis, playing a central role in both local tumour growth and distant metastasis formation [2]. Multiple angiogenic factors are commonly expressed by invasive breast cancers and the 121-amino-acid isoform of vascular endothelial growth factor (VEGF) predominates [3].Bevacizumab (BEV) (Avastin？, F. Hoffmann-La Roche Ltd) is a recombinant humanized monoclonal antibody against VEGF. Preclinical in vivo models demonstrate that BEV inhibits growth of a variety of human cancer cell lines in a dose dependent manner. In addition, by eliminating the excess VEGF, the newly formed tumour vessels become less permeable, resulting thus in reduction of interstitial pressure. It has be