Bevacizumab, etoposide, and cisplatin (BEEP) in brain metastases of breast cancer progressing from radiotherapy: Results of the first stage of a multicenter phase II study.

Authors

null

Yen-Shen Lu

Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan

Yen-Shen Lu , Wei-Wu Chen , Ching-Hung Lin , Ling-Ming Tseng , Dah-Cherng Yeh , Pei-Fang Wu , Bang-Bin Chen , Ta-Chung Chao , Yi-Fang Tsai , Shu-Min Huang , Tiffany Ting-Fang Shih , Ann-Lii Cheng

Organizations

Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan, National Taiwan University Hospital, Taipei, Taiwan, Taipei Veterans General Hospital, Taipei, Taiwan, Department of Surgery, Taichung Veterans General Hospital, Taichung City, Taiwan, Department of Medical Imaging and Radiology, National Taiwan University Hospital, Taipei, Taiwan, Division of Hematology-Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Division of General Surgery, Department of Surgery, Taipei-Veterans General Hospital, Taipei, Taiwan

Research Funding

Other
Background: With a general prolongation of survival, brain metastasis (BM) has become a common complication of breast cancer. However, management of BM remains a severe challenge. We hypothesized that bevacizumab (BE) could significantly enhance drug delivery of etoposide (E) and cisplatin (P), two of the cytotoxic agents that have moderate activity in BM of breast cancer, to brain tumors and thereby improve the efficacy. Methods: Breast cancer patients (pts) with BM progression after whole brain radiotherapy (WBRT) were enrolled. Pts received BE 15 mg/kg day 1, and E 70 mg/m2/day, days 2-4, P 70 mg/m2/day, day 2, every 21 days for a maximum of 6 cycles. The primary endpoint was a centrally assessed CNS objective response (CNS-OR) defined as a ≥50% reduction in the volumetric sum of all measurable CNS lesions in the absence of increasing steroid use, development of new CNS lesion, or progressive neurologic symptoms. Using a Simon’s optimal two-stage design with 15% as a minimum interest in CNS-OR rate (by intent to treat analysis), 11 pts were needed at the first stage; and a total of 31 evaluable for the whole study. Results: Among 16 pts enrolled from Jan 2011 to Jan 2012, 12 pts were evaluable for treatment response at the time of abstract submission. Median age was 55 (range 34-66); 1 pt was ER+HER2-, 5 pts were HER2+, and 6 pts were ER-HER2-. The median treatment cycles were 4.5 (range 1-6). Nine of 12 pts (75%; 95%CI 42.8-94.5) achieved CNS-OR including 6 pts (50%) with ≥80% and 3 pts (25%) with 50-80% CNS volumetric reduction, respectively. Two pts had non-CNS disease progression while CNS tumors remained under control. The median CNS progression free survival was 6.6 months (95% CI 0.8-12.4). Grade 3 /4 toxicities included neutropenia, leukopenia, anemia, and platelet in 13 (25.5%), 6 (11.8%), 2 (3.9%), and 2 (3.9%) cycles, respectively. Seven pts (58.3%) had received dose reduction to E 60 mg/m2 and P 60 mg/m2. Early reporting of this study was approved by Data and Safety Monitoring Committeedue to an extremely promising result. Conclusions: BEEP regimen has a significant anti-tumor effect for BM of breast cancer which progresses after WBRT.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2012 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Breast Cancer - Triple-Negative/Cytotoxics/Local Therapy

Track

Breast Cancer

Sub Track

Cytotoxic Chemotherapy

Clinical Trial Registration Number

NCT01281696

Citation

J Clin Oncol 30, 2012 (suppl; abstr 1079)

DOI

10.1200/jco.2012.30.15_suppl.1079

Abstract #

1079

Poster Bd #

24F

Abstract Disclosures