Randomized phase III trial of capecitabine compared with bevacizumab plus capecitabine in patients with previously treated metastatic breast cancer

Kathy Miller, Linnea I. Chap, Frankie A. Holmes, Melody A. Cobleigh, P. Kelly Marcom, Louis Fehrenbacher, Maura Dickler, Beth A. Overmoyer, James D. Reimann, Amy P. Sing, Virginia Langmuir, Hope S. Rugo

Research output: Contribution to journalArticle

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Abstract

Purpose: This randomized phase III trial compared the efficacy and safety of capecitabine with or without bevacizumab, a monoclonal antibody to vascular endothelial growth factor, in patients with metastatic breast cancer previously treated with an anthracycline and a taxane. Patients and Methods: Patients were randomly assigned to receive capecitabine (2,500 mg/m2/d) twice daily on day 1 through 14 every 3 weeks, alone or in combination with bevacizumab (15 mg/kg) on day 1. The primary end point was progression-free survival (PFS), as determined by an independent review facility. Results: From November 2000 to March 2002, 462 patients were enrolled. Treatment arms were balanced. No significant differences were found in the incidence of diarrhea, hand-foot syndrome, thromboembolic events, or serious bleeding episodes between treatment groups. Of other grade 3 or 4 adverse events, only hypertension requiring treatment (17.9% v 0.5%) was more frequent in patients receiving bevacizumab. Combination therapy significantly increased the response rates (19.8% v 9.1%, P = .001); however, this did not result in a longer PFS (4.86 v4.17 months; hazard ratio = 0.98). Overall survival (15.1 v 14.5 months) and time to deterioration in quality of life as measured by the Functional Assessment Of Cancer Treatment-Breast were comparable in both treatment groups. Conclusion: Bevacizumab was well tolerated in this heavily pretreated patient population. Although the addition of bevacizumab to capecitabine produced a significant increase in response rates, this did not translate into improved PFS or overall survival.

Original languageEnglish
Pages (from-to)792-799
Number of pages8
JournalJournal of Clinical Oncology
Volume23
Issue number4
DOIs
StatePublished - 2005

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Breast Neoplasms
Disease-Free Survival
Therapeutics
Hand-Foot Syndrome
Survival
Anthracyclines
Vascular Endothelial Growth Factor A
Bevacizumab
Capecitabine
Diarrhea
Monoclonal Antibodies
Quality of Life
Hemorrhage
Hypertension
Safety
Incidence
Population

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Randomized phase III trial of capecitabine compared with bevacizumab plus capecitabine in patients with previously treated metastatic breast cancer. / Miller, Kathy; Chap, Linnea I.; Holmes, Frankie A.; Cobleigh, Melody A.; Marcom, P. Kelly; Fehrenbacher, Louis; Dickler, Maura; Overmoyer, Beth A.; Reimann, James D.; Sing, Amy P.; Langmuir, Virginia; Rugo, Hope S.

In: Journal of Clinical Oncology, Vol. 23, No. 4, 2005, p. 792-799.

Research output: Contribution to journalArticle

Miller, K, Chap, LI, Holmes, FA, Cobleigh, MA, Marcom, PK, Fehrenbacher, L, Dickler, M, Overmoyer, BA, Reimann, JD, Sing, AP, Langmuir, V & Rugo, HS 2005, 'Randomized phase III trial of capecitabine compared with bevacizumab plus capecitabine in patients with previously treated metastatic breast cancer', Journal of Clinical Oncology, vol. 23, no. 4, pp. 792-799. https://doi.org/10.1200/JCO.2005.05.098
Miller, Kathy ; Chap, Linnea I. ; Holmes, Frankie A. ; Cobleigh, Melody A. ; Marcom, P. Kelly ; Fehrenbacher, Louis ; Dickler, Maura ; Overmoyer, Beth A. ; Reimann, James D. ; Sing, Amy P. ; Langmuir, Virginia ; Rugo, Hope S. / Randomized phase III trial of capecitabine compared with bevacizumab plus capecitabine in patients with previously treated metastatic breast cancer. In: Journal of Clinical Oncology. 2005 ; Vol. 23, No. 4. pp. 792-799.
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AU - Miller, Kathy

AU - Chap, Linnea I.

AU - Holmes, Frankie A.

AU - Cobleigh, Melody A.

AU - Marcom, P. Kelly

AU - Fehrenbacher, Louis

AU - Dickler, Maura

AU - Overmoyer, Beth A.

AU - Reimann, James D.

AU - Sing, Amy P.

AU - Langmuir, Virginia

AU - Rugo, Hope S.

PY - 2005

Y1 - 2005

N2 - Purpose: This randomized phase III trial compared the efficacy and safety of capecitabine with or without bevacizumab, a monoclonal antibody to vascular endothelial growth factor, in patients with metastatic breast cancer previously treated with an anthracycline and a taxane. Patients and Methods: Patients were randomly assigned to receive capecitabine (2,500 mg/m2/d) twice daily on day 1 through 14 every 3 weeks, alone or in combination with bevacizumab (15 mg/kg) on day 1. The primary end point was progression-free survival (PFS), as determined by an independent review facility. Results: From November 2000 to March 2002, 462 patients were enrolled. Treatment arms were balanced. No significant differences were found in the incidence of diarrhea, hand-foot syndrome, thromboembolic events, or serious bleeding episodes between treatment groups. Of other grade 3 or 4 adverse events, only hypertension requiring treatment (17.9% v 0.5%) was more frequent in patients receiving bevacizumab. Combination therapy significantly increased the response rates (19.8% v 9.1%, P = .001); however, this did not result in a longer PFS (4.86 v4.17 months; hazard ratio = 0.98). Overall survival (15.1 v 14.5 months) and time to deterioration in quality of life as measured by the Functional Assessment Of Cancer Treatment-Breast were comparable in both treatment groups. Conclusion: Bevacizumab was well tolerated in this heavily pretreated patient population. Although the addition of bevacizumab to capecitabine produced a significant increase in response rates, this did not translate into improved PFS or overall survival.

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