Selecting first-line bevacizumab-containing therapy for advanced breast cancer: TURANDOT risk factor analyses

T. Brodowicz, I. Lang, Z. Kahan, R. Greil, S. Beslija, S. M. Stemmer, B. Kaufman, L. Petruzelka, A. Eniu, R. Anghel, K. Koynov, D. Vrbanec, T. Pienkowski, B. Melichar, S. Spanik, S. Ahlers, D. Messinger, M. J. Inbar, C. Zielinski*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: The randomised phase III TURANDOT trial compared first-line bevacizumab-paclitaxel (BEV-PAC) vs bevacizumab-capecitabine (BEV-CAP) in HER2-negative locally recurrent/metastatic breast cancer (LR/mBC). The interim analysis revealed no difference in overall survival (OS; primary end point) between treatment arms; however, progression-free survival (PFS) and objective response rate were significantly superior with BEV-PAC. We sought to identify patient populations that may be most appropriately treated with one or other regimen.Methods:Patients with HER2-negative LR/mBC who had received no prior chemotherapy for advanced disease were randomised to either BEV-PAC (bevacizumab 10 mg kg-1 days 1 and 15 plus paclitaxel 90 mg m-2 days 1, 8 and 15 q4w) or BEV-CAP (bevacizumab 15 mg kg-1 day 1 plus capecitabine 1000 mg m-2 bid days 1-14 q3w). The study population was categorised into three cohorts: triple-negative breast cancer (TNBC), high-risk hormone receptor-positive (HR+) and low-risk HR+. High-and low-risk HR+ were defined, respectively, as having ≥2 vs ≤1 of the following four risk factors: disease-free interval ≤24 months; visceral metastases; prior (neo)adjuvant anthracycline and/or taxane; and metastases in ≥3 organs. Results: The treatment effect on OS differed between cohorts. Non-significant OS trends favoured BEV-PAC in the TNBC cohort and BEV-CAP in the low-risk HR+ cohort. In all three cohorts, there was a non-significant PFS trend favouring BEV-PAC. Grade ≥3 adverse events were consistently less common with BEV-CAP. Conclusions: A simple risk factor index may help in selecting bevacizumab-containing regimens, balancing outcome, safety profile and patient preference. Final OS results are expected in 2015 ( NCT00600340).

Original languageEnglish
Pages (from-to)2051-2057
Number of pages7
JournalBritish Journal of Cancer
Issue number11
StatePublished - 25 Nov 2014
Externally publishedYes


  • bevacizumab
  • metastatic breast cancer
  • risk factor-prognostic index
  • triple-negative breast cancer


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