Maintenance endocrine therapy plus bevacizumab for advanced or metastatic breast cancer
Mené au Japon sur 160 patientes atteintes d'un cancer du sein ER+ HER2- de stade avancé ou métastatique (âge : 20-75 ans), cet essai de phase II évalue l'efficacité, du point de vue du délai avant échec de la stratégie, et la toxicité d'une thérapie endocrinienne d'entretien en combinaison avec du bévacizumab, en remplacement d'une chimiothérapie d'induction de première ligne à base de paclitaxel et de bévacizumab
Endocrine therapy is the preferred option for patients with hormone receptor-positive,HER2-negative advanced or metastatic breast cancer. However, first-line chemotherapy is used in approximately half of this patient population,notably in the context of organ failure or resistance to endocrine therapy. In these patients, chemotherapy is frequently stopped, despite disease stabilisation,because of acute and cumulative toxic effects. Switching to maintenance endocrine therapy after first-line induction chemotherapyhas been proposed to improve disease control and to maintain quality of life (QOL).Switch maintenance therapy is regularly used in clinical practice, although clinical trials attesting to its relevance are scarce. Moreover, the first-line combination of bevacizumab (an anti-angiogenic monoclonalantibody) plus chemotherapy has been shown in clinical trials to improve progression-freesurvival, although its effect on overall survival remains controversial. These results have led to the consideration of this combination as an acceptablefirst-line strategy. Similarly, bevacizumab plus endocrine therapy is efficacious in improving progression-freesurvival and overall survival while being well tolerated as a first-line treatmentfor advanced or metastatic breast cancer.
The Lancet Oncology , commentaire, 2021