RIBBON-2 results demonstrated that adding bevacizumab to chemotherapy as a second-line treatment for metastatic breast cancer significantly improved progression-free survival.
"Potentially, we have another biologic agent that can improve the survival or at least the progression-free survival of women with metastatic breast cancer," said Dr. Adam Brufsky, associate professor of medicine, associate chief of haematology-oncology and associate director of clinical investigation, University of Pittsburgh Cancer Institute.
"Clearly, this may be an indication to use bevacizumab in this setting, but we really have to consider the results of this trial in terms of how best to use these drugs in metastatic breast cancer."
Results of three phase III studies - E2100, AVADO and RIBBON-1 - have shown the clinical benefit of adding bevacizumab to chemotherapy as a first-line metastatic breast cancer treatment. Brufsky and colleagues designed RIBBON-2 to evaluate the efficacy and safety of adding bevacizumab to chemotherapy as a second-line treatment of metastatic breast cancer.
The study included 684 patients in 19 countries at 211 sites. Patients were eligible if they met the following criteria: one prior cytotoxic treatment for metastatic breast cancer, Eastern Cooperative Oncology Group performance status of 0 to 1, HER2 negative disease and no central nervous system metastases.
The primary endpoint was progression-free survival; secondary endpoints included overall survival, overall response rate, duration of response and safety. Researchers randomly assigned patients to chemotherapy plus bevacizumab or chemotherapy plus placebo.
The results were predictable, Brufsky said. Adding bevacizumab to various chemotherapy regimens as a second-line metastatic breast cancer treatment significantly improved progression-free survival.
"The fact that bevacizumab has a benefit in first- and second-line treatment really begs the question: Should we be giving this drug to someone through the entire course of metastatic disease?" he said.
To address this question, Brufsky and colleagues are considering conducting a long-term clinical trial that to compare bevacizumab or no bevacizumab treatment in women with metastatic breast cancer.
Watch a press briefing by Prof Adam Brufsky on ecancertv here.
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