showing a statistically significant increase in PFS, resulting in a reduced risk of progression of about 30%. In the meta-analysis conducted by Valachis et al, improved PFS was statistically significant only in the subgroup of patients receiving taxanes (or anthracyclines in a part of the study RIBBON-1) in combination with Bevacizumab [33], this advantage not seem to get in combination with capecitabine, although the latter are grouped in heterogeneous populations with regard to the treatment line. In the meta-analysis conducted by Lee et al, with populations more correctly grouped by line of treatment rather than medication, the benefit of
the addition of Bevacizumab in PFS is restricted to first-line treatment [32]. Moreover, this analysis shows learn more a marginal but statistically significant benefit in overall survival in first line. At the last ESMO meeting, a meta-analysis of 530 elderly patients (older than 65 years) enrolled in the selleck products randomized trials ECOG 2100, AVADO and RIBBON-1, was presented [34]. Although that represent a subgroup analysis, even in these featured advanced breast cancer patients’ sample, bevacizumab in combination with chemotherapy was associated with significantly improved PFS versus chemotherapy alone (HR 0.67, p = 0.0030). Hypertension was more frequent with the addition of bevacizumab,
as expected; besides, no differences according to age were found. Another relevant issue that emerges from our analysis is that the prior exposure to treatments containing taxanes does not affect the efficacy of bevacizumab (Table
4). Indeed, the meta-regression analysis for either PFS Selleckchem BI 6727 or OS clearly indicates that no significant correlation exists between the efficacy of bevacizumab and taxanes pre-treatment (p = 0.96 and p = 0.45, respectively). This finding is consistent with the ECOG-2100 and AVADO previous release [14, 15], and with the recently presented meta-analysis of patients from studies ECOG-2100, AVADO and RIBBON-1, previously treated with taxanes (paclitaxel, docetaxel or paclitaxel protein-bound) [35]. This analysis included only 311 patients from the group of patients Lepirudin treated with taxanes of the RIBBON-1 and AVADO who received bevacizumab 15 mg/kg. The addition of bevacizumab led to an improvement in PFS from 6.2 to 10.6 months (HR 0.50, 95% CI 0.36-0.69). In line with the data of the single trials and our analysis, the authors conclude that patients pretreated with taxanes are good candidates for retreatment with bevacizumab and taxane [35]. With regard to serious adverse events, the main significant toxicity against the addition of bevacizumab was hypertension (Table 3); this represents a common finding in all disease setting when this monoclonal antibody is adopted. Our analysis shows that a weighted average of 4.5% difference between the control arm and patients undergoing bevacizumab was found, corresponding to 22 patients to be treated for one harmed (Table 3).