• B Gerber, S Loibl, H Eidtmann, M Rezai, P A Fasching, H Tesch, H Eggemann, I Schrader, K Kittel, C Hanusch, R Kreienberg, C Solbach, C Jackisch, G Kunz, J U Blohmer, J Huober, M Hauschild, V Nekljudova, M Untch, G von Minckwitz, and German Breast Group Investigators.
• Department of Obstetrics and Gynaecology, University of Rostock, Rostock.
• Ann. Oncol. 2013 Dec 1;24(12):2978-84.

BackgroundWe evaluated the pathological complete response (pCR) rate after neoadjuvant epirubicin, (E) cyclophosphamide (C) and docetaxel containing chemotherapy with and without the addition of bevacizumab in patients with triple-negative breast cancer (TNBC).Patients And MethodsPatients with untreated cT1c-4d TNBC represented a stratified subset of the 1948 participants of the HER2-negative part of the GeparQuinto trial. Patients were randomized to receive four cycles EC (90/600 mg/m(2); q3w) followed by four cycles docetaxel (100 mg/m(2); q3w) each with or without bevacizumab (15 mg/kg; q3w) added to chemotherapy.ResultsTNBC patients were randomized to chemotherapy without (n = 340) or with bevacizumab (n = 323). pCR (ypT0 ypN0, primary end point) rates were 27.9% without and 39.3% with bevacizumab (P = 0.003). According to other pCR definitions, the addition of bevacizumab increased the pCR rate from 30.9% to 41.8% (ypT0 ypN0/+; P = 0.004), 36.2% to 46.4% (ypT0/is ypN0/+; P = 0.009) and 32.9% to 43.3% (ypT0/is ypN0; P = 0.007). Bevacizumab treatment [OR 1.73, 95% confidence interval (CI) 1.23-2.42; P = 0.002], lower tumor stage (OR 2.38, 95% CI 1.24-4.54; P = 0.009) and grade 3 tumors (OR 1.68, 95% CI 1.14-2.48; P = 0.009) were confirmed as independent predictors of higher pCR in multivariate logistic regression analysis.ConclusionsThe addition of bevacizumab to chemotherapy in TNBC significantly increases pCR rates.

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