Valutazione di efficacia di un antiangiogenetico (Bevacizumab) associato a chemioterapia in pazienti con carcinoma della mammella metastatico

Aim: Cancer development requires neovascularization. The level of angiogenic activity in breast cancer has been shown to be a determinant of disease progression and survival. Bevacizumab is a recombinant humanized monoclonal antibody to VEGF Preclinical data suggested its synergism with traditional cytotoxic chemotherapy. The aim of the study is evaluate the efficacy of bevacizumab with chemotherapy as first line therapy for patients who have metastatic breast cancer, and surrogate markers for angiogenesis.Methods: Eighteen women with previously untreated metastatic HER-2 negative breast cancer were assigned to receive Bevacizumab 15 mg/kg Q3W plus taxane based chemotherapy (Docetaxel 100 mg/mq or Paclitaxel 175 mg Q3W) until anacceptable toxicity or progression disease. We investigated the relationship between VEGF and VEGFR density (immunoistochimical score) in evaluated in tissue samples with the ORR.Results: After a median of 20 weeks, only 2 patients stopped treatment for anti VEGF correlated toxicity G4. Adding Bevacizumab to taxane chemotherapy produced highly statistically significant greater OR: we registred five complete responses (CR=27,7%), six partial responses (PR=33,3%), two stable disease (SD=11,1%); there were only three progressions disease (PD= 16,6%); two patients of these died (11,1%) (mTTP= 15,5 mounths).We found that VEGF and VEGFR density was not statistically significance with response to Bevacizumab.Conclusions: Globally the anti VEGF therapy has been well tolerated and a good ORR (overall response rate) has been shown.Translational research is necessary to identify prognostic and predictive antiangiogenesis surrogate markers.