Resumen de Bevacizumab plus preoperative chemotherapy in operable HER2 negative breast cancer: biomarkers and pathologic response
Pedro Sánchez Rovira, Miguel Ángel Seguí Palmer, Antonio Llombart Cussac, Enrique Aranda Aguilar, A. Antón Torres, Alfonso Sánchez Muñoz, María Lomas Garrido, Ana Jaén, M. Fernández Morales, Ignacio Porras Quintela, Elsa Dalmau Pórtulas, S. Morales Murillo, Juan Rafael Haba Rodríguez
Purpose The primary aim of this trial was to assess the rate of pathologic complete responses (pCR) of doxorubicin/cyclophosphamide (AC) followed by bevacizumab/docetaxel (BT), as neoadjuvant therapy for breast cancer (BC). Furthermore, the association between biomarkers and the pCR was explored.
Methods Patients with HER-negative operable stage II�III BC ?2 cm were enrolled. Four cycles of AC (A 60 mg/m2 and C 600 mg/m2, every 3 weeks) followed by 4 cycles of BT (B 15 mg/kg and T 75 mg/m2, every 3 weeks), were planned. A core-biopsy was performed for biological markers assessment.
Results Seventy-two women were included. Forty-three (63 %) patients were hormone receptor-positive. Sixty-four (89 %) completed the planned treatment, and 66 evaluable patients underwent surgery (92 %): a pCR was achieved in 16 of them (24, 95 % CI 15�36 %). pCR was significantly higher in tumors hormone receptor-negative, and in those with Angiotensin II type 1 receptor (AGTR1) protein overexpression. The overall clinical response rate was 86 % (95 % CI 76�93 %), including 42 complete responses. No unexpected toxicities or treatment-related deaths were observed.
Conclusion This regimen showed a remarkable clinical and pathological activity: the suggested relation between pCR and AGTR1 overexpression should be confirmed in larger trials.
