Phase II trial of neoadjuvant weekly nanoparticle albumin-bound paclitaxel, carboplatin, and biweekly bevacizumab therapy in women with clinical stage II or III HER2-negative breast cancer

Abstract

Background: We hypothesized that adding bevacizumab to neoadjuvant chemotherapy (NCT) with nab-P and carboplatin would increase the rates of pCR in BC patients and that early changes in tumor vascularity imaged by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) would predict pCR.

Methods: Thirty-three women with clinical stage II or III HER2-negative BC received nab-P 100 mg/m2 and carboplatin area under the curve = 2 on days 1, 8, and 15 in combination with bevacizumab 10 mg/kg on days 1 and 15 administered every 28 days.

Results: Six patients (18%) achieved pCR, all pCRs occurred in triple-negative BC (TNBC) (pCR = 50% for TNBC). At the end of cycle 2, the changes in relative angiogenic volume were significantly different between responders and nonresponders (P = .001). The major toxicity of this NCT was myelosuppression.

Conclusion: NCT with weekly nab-P, carboplatin, and biweekly bevacizumab resulted in a pCR rate that was neither superior to the historical data with anthracycline- or taxane-containing NCT nor to carboplatin and taxane combinations in patients with HER2-negative BC. In patients with TNBC, the observed pCR rate was 50%. The early changes in the relative angiogenic volume imaged by DCE-MRI could predict pCR.

Keywords: Carboplatin; Human epidermal growth factor receptor–negative breast cancer; Nanoparticle albumin-bound paclitaxel; Neoadjuvant chemotherapy; Pathologic complete response.

Conflict of interest statement

The authors have stated that they have no additional confiicts of interest.

Copyright © 2014 Elsevier Inc. All rights reserved.

Figures

Figure 1

Post–Neoadjuvant Chemotherapy Drop in Relative Angiogenic Volume for the Triple-Negative (n = 10) and Non–Triple-Negative Breast Cancer Patients (n = 10) Relative angiogenic volume = (ΔVAngio/VGeo). Abbreviations: ER = estrogen receptor; PR = progesterone receptor; VAngio = angiogenic volume; VGeo = geometric volume.