Window of opportunity: A new insight into sequential bevacizumab and paclitaxel in two cases of metastatic triple‑negative breast cancer

Chen,Dar‑Ren; Lin,Che; Wang,Yu‑Fen

doi:10.3892/etm.2015.2586

Window of opportunity: A new insight into sequential bevacizumab and paclitaxel in two cases of metastatic triple‑negative breast cancer

Authors:
- Dar‑Ren Chen
- Che Lin
- Yu‑Fen Wang
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Affiliations: Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua 50006, Taiwan, R.O.C., Cancer Research Center, Changhua Christian Hospital, Changhua 50006, Taiwan, R.O.C.
Published online on: June 23, 2015 https://doi.org/10.3892/etm.2015.2586
Pages: 885-888
Copyright: © Chen et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Bevacizumab, an antiangiogenic monoclonal antibody against vascular endothelial growth factor, was designed to normalize tumor vasculature and reduce intratumoral pressure. It can create a ‘normalization window’ during which the cancer can be attacked the most effectively, and the effects of chemotherapeutic drugs are enhanced. Representative trials (E2100, AVADO, RIBBON‑1, RIBBON‑2 and TURANDOT) have shown that the addition of bevacizumab to chemotherapy has significant benefits on progression‑free survival for metastatic breast cancer, but not on overall survival. The present study describes two patients with metastatic triple‑negative breast cancer who received 6 courses of bevacizumab‑containing chemotherapy. Each course comprised 5‑7.5 mg/kg bevacizumab administered on days 1 and 15, and 20‑24 h after bevacizumab delivery, 80 mg/m2 paclitaxel was administered for 3 weeks on days 2, 9 and 16, followed by 1 week of rest. Following sequential treatment with bevacizumab and paclitaxel, the results of computed tomography showed that the tumors were rapidly reduced in size. Based on the imaging findings from three‑dimension power Doppler ultrasonography in one of the breast cancer patients who received neoadjuvant chemotherapy with bevacizumab, the possible timing of the normalization window was 20‑24 h after the administration of bevacizumab. The normalization window may provide an opportunity to enhance the effect of chemotherapy with the aid of bevacizumab.

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1	Miller K, Wang M, Gralow J, et al: Paclitaxel plus bevacizumab versus paclitaxel alone for metastatic breast cancer. N Engl J Med. 357:2666–2676. 2007. View Article : Google Scholar : PubMed/NCBI
2	Miles DW, Chan A, Dirix LY, et al: Phase III study of bevacizumab plus docetaxel compared with placebo plus docetaxel for the first-line treatment of human epidermal growth factor receptor 2-negative metastatic breast cancer. J Clin Oncol. 28:3239–3247. 2010. View Article : Google Scholar : PubMed/NCBI
3	Robert NJ, Diéras V, Glaspy J, et al: RIBBON-1: Randomized, double-blind, placebo-controlled, phase III trial of chemotherapy with or without bevacizumab for first-line treatment of human epidermal growth factor receptor 2-negative, locally recurrent or metastatic breast cancer. J Clin Oncol. 29:1252–1260. 2011. View Article : Google Scholar : PubMed/NCBI
4	Lang I, Brodowicz T, Ryvo L, et al: Central European Cooperative Oncology Group: Bevacizumab plus paclitaxel versus bevacizumab plus capecitabine as first-line treatment for HER2-negative metastatic breast cancer: Interim efficacy results of the randomised, open-label, non-inferiority, phase 3 TURANDOT trial. Lancet Oncol. 14:125–133. 2013. View Article : Google Scholar : PubMed/NCBI
5	Brufsky AM, Hurvitz S, Perez E, Swamy R, Valero V, ONeill V and Rugo HS: RIBBON-2: A randomized, double-blind, placebo-controlled, phase III trial evaluating the efficacy and safety of bevacizumab in combination with chemotherapy for second-line treatment of human epidermal growth factor receptor 2-negative metastatic breast cancer. J Clin Oncol. 29:4286–4293. 2011. View Article : Google Scholar : PubMed/NCBI
6	Pugh CW and Ratcliffe PJ: Regulation of angiogenesis by hypoxia: Role of the HIF system. Nat Med. 9:677–684. 2003. View Article : Google Scholar : PubMed/NCBI
7	Jain RK: Normalizing tumor vasculature with anti-angiogenic therapy: A new paradigm for combination therapy. Nat Med. 7:987–989. 2001. View Article : Google Scholar : PubMed/NCBI
8	Willett CG, Boucher Y, di Tomaso E, et al: Direct evidence that the VEGF-specific antibody bevacizumab has antivascular effects in human rectal cancer. Nat Med. 10:145–147. 2004. View Article : Google Scholar : PubMed/NCBI
9	Vakoc BJ, Lanning RM, Tyrrell JA, et al: Three-dimensional microscopy of the tumor microenvironment in vivo using optical frequency domain imaging. Nat Med. 15:1219–1223. 2009. View Article : Google Scholar : PubMed/NCBI
10	Winkler F, Kozin SV, Tong RT, et al: Kinetics of vascular normalization by VEGFR2 blockade governs brain tumor response to radiation: Role of oxygenation, angiopoietin-1 and matrix metalloproteinases. Cancer Cell. 6:553–563. 2004. View Article : Google Scholar : PubMed/NCBI
11	Jain RK: Taming vessels to treat cancer. Sci Am. 298:56–63. 2008. View Article : Google Scholar : PubMed/NCBI
12	Gianni L, Romieu GH, Lichinitser M, et al: AVEREL: A randomized phase III trial evaluating bevacizumab in combination with docetaxel and trastuzumab as first-line therapy for her2-positive locally recurrent/metastatic breast cancer. J Clin Oncol. 31:1719–1725. 2013. View Article : Google Scholar : PubMed/NCBI
13	Miles DW, de Haas SL, Dirix LY, et al: Biomarker results from the AVADO phase 3 trial of first-line bevacizumab plus docetaxel for HER2-negative metastatic breast cancer. Br J Cancer. 108:1052–1060. 2013. View Article : Google Scholar : PubMed/NCBI
14	Hegde PS, Jubb AM, Chen D, et al: Predictive impact of circulating vascular endothelial growth factor in four phase III trials evaluating bevacizumab. Clin Cancer Res. 19:929–937. 2013. View Article : Google Scholar : PubMed/NCBI
15	Goel S, Duda DG, Xu L, et al: Normalization of the vasculature for treatment of cancer and other diseases. Physiol Rev. 91:1071–1121. 2011. View Article : Google Scholar : PubMed/NCBI
16	Goel S, Wong AH and Jain RK: Vascular normalization as a therapeutic strategy for malignant and nonmalignant disease. Cold Spring Harb Perspect Med. 2:a0064862012. View Article : Google Scholar : PubMed/NCBI
17	Giuliano S and Pagès G: Mechanisms of resistance to anti-angiogenesis therapies. Biochimie. 95:1110–1119. 2013. View Article : Google Scholar : PubMed/NCBI
18	Yuan F, Chen Y, Dellian M, Safabakhsh N, Ferrara N and Jain RK: Time-dependent vascular regression and permeability changes in established human tumor xenografts induced by an anti-vascular endothelial growth factor/vascular permeability factor antibody. Proc Natl Acad Sci USA. 93:14765–14770. 1996. View Article : Google Scholar : PubMed/NCBI
19	Dickler MN, Barry WT, Cirrincione CT, Ellis MJ, Moynahan ME, Innocenti F, Hurria A, Rugo HS, Lake D, Hahn OM, et al: Phase III trial evaluating the addition of bevacizumab to letrozole as first-line endocrine therapy for treatment of hormone-receptor positive advanced breast cancer: CALGB 40503 (Alliance). J Clin Oncol. 33:(Suppl). 5012015.PubMed/NCBI
20	Bragalone DL: Drug Information Handbook for Oncology. 10th. Lexicomp; Hudson, OH: pp. 501–514. 2012