Bevacizumab and paclitaxel for breast cancer patients with central nervous system metastases: a case series.

Abstract

Central nervous system (CNS) metastases are a major concern in patients with stage IV breast cancer. Recent studies have shown the efficacy of anti-vascular endothelial growth factor drugs on brain tumors, in particular glioblastoma, but none has explored their efficacy and tolerance in breast cancer patients with CNS metastases. We report 4 cases of patients with CNS metastases treated with bevacizumab and paclitaxel. All but 1 had previous whole-brain radiation therapy, performance status 0-2, and radiographic evidence of progressive CNS metastases. Patients received paclitaxel 80 mg/m2 on days 1, 8, and 15, and bevacizumab 10 mg/kg on days 1 and 15. Response was evaluated according to the World Health Organization criteria. Three patients had brain metastases, and 1 had meningeal lesions. Only 1 patient was chemotherapy-naive. Significant antitumor activity was observed, with 1 complete response and 3 partial responses in the CNS metastases. With a mean follow-up of 9 months, duration of response was 11, 10, 8, and 6 months. No patient had extra-CNS progression. This observed antitumor activity suggests efficiency of the combination of bevacizumab and paclitaxel and warrants further evaluation of this combination as an alternative option for the treatment of multiple CNS metastases in breast cancer.

• Authors: Sana Intidhar Labidi, Thomas Bachelot, Isabelle Ray-Coquard, Karim Mosbah, Isabelle Treilleux, Jerome Fayette, Bertrand Favier, Guillaume Galy, Jean-Yves Blay, Jean-Paul Guastalla
• Journal: Clinical breast cancer (Clin Breast Cancer) Vol. 9 Issue 2 Pg. 118-21 (May 2009) ISSN: 1526-8209 [Print] United States
• PMID: 19433393 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Receptors, Estrogen
• Receptors, Progesterone
• Bevacizumab
• Receptor, ErbB-2
• Paclitaxel

Topics

• Adult
• Antibodies, Monoclonal (administration & dosage)
• Antibodies, Monoclonal, Humanized
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Bevacizumab
• Brain Neoplasms (drug therapy, metabolism, secondary)
• Breast Neoplasms (drug therapy, metabolism, pathology)
• Carcinoma, Ductal, Breast (drug therapy, metabolism, secondary)
• Female
• Humans
• Magnetic Resonance Imaging
• Middle Aged
• Neoplasm Staging
• Neoplasms, Hormone-Dependent (metabolism)
• Paclitaxel (administration & dosage)
• Prognosis
• Receptor, ErbB-2 (metabolism)
• Receptors, Estrogen (metabolism)
• Receptors, Progesterone (metabolism)
• Survival Rate
• Treatment Outcome