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Cancer Resources > Cancer News > Cancer News from Reuters > Reuters Cancer News > 2009 > October
Letrozole and bevacizumab promising against breast cancer
David Douglas
Last Updated: 2009-10-30 16:45:04 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Letrozole plus bevacizumab appears to be a safe approach in patients with hormone receptor-positive metastatic breast cancer, researchers report in the Journal of Clinical Oncology, released on October 15.
"This study," senior investigator Dr. Maura N. Dickler told Reuters Health, "was designed as a feasibility trial to test the safety of letrozole in combination with bevacizumab, an anti-VEGF antibody."
"The rationale for this combination," she added, "is based on animal models that suggest tumor angiogenesis as a mechanism that may help hormone-dependent breast cancers escape the effects of anti-estrogen therapy."
Dr. Dickler of Memorial Sloan-Kettering Cancer Center, New York, and colleagues studied 43 patients who received letrozole, 2.5 mg orally daily, and bevacizumab 15 mg/kg IV every 3 weeks.
All patients were evaluable for toxicity and response. Treatment-related toxicities included hypertension (58%), proteinuria (67%), headache (51%) and fatigue (74%). Nine patients withdrew from the study because of drug-related toxicities, including 3 with proteinuria, 3 with hypertension, and one each with hyponatremia, headache, and thrombocytopenia with portal hypertension.
Efficacy results were confounded because 36 of the patients (84%) had already been taking non-steroidal anti-inflammatory drugs. Overall, partial responses were seen in 4 patients (9%) and stable disease for at least 24 weeks was noted in 29 subjects (67%). The median progression-free survival was 17.1 months.
"By targeting tumor angiogenesis in combination with estrogen-lowering therapy," continued Dr. Dickler, "we hope to determine whether we can delay the development of resistance to standard endocrine therapy and therefore delay progression of metastatic disease."
"This feasibility study," she concluded, "has led to a proof of concept study that is testing endocrine therapy -- either letrozole or tamoxifen, per physician discretion -- with or without bevacizumab in patients with hormone-receptor positive metastatic breast cancer in a randomized, double-blind phase III study that is presently accruing patients."
J Clin Oncol 2009.
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