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Avastin May Be Helpful Before Breast Cancer Surgery
Date:1/25/2012

d surgery to remove their tumors. All of the women had tumors that were at least 2 centimeters (about 0.8 inches) in diameter, and none had metastatic cancer.

The women received chemotherapy before surgery (neoadjuvant therapy). They were randomly assigned to treatment groups that included the chemotherapy drugs docetaxel, capecitabine and gemcitabine in various doses and combinations. They were also randomly assigned to receive Avastin or not during their first six cycles of chemotherapy.

The study found that adding capecitabine or gemcitabine to docetaxel therapy didn't improve response rates. But the addition of Avastin increased the rate of "pathological complete response" -- meaning the tumor disappeared before surgery -- from 28.2 percent to 34.5 percent, according to the study.

However, the addition of Avastin also increased the risk of serious side effects, such as high blood pressure and heart problems.

The second study, conducted in Germany, included 1,948 women with an average tumor size of 4 centimeters (about 1.6 inches). As in Bear's study, the women were randomly assigned to several neoadjuvant chemotherapy groups. In this study, however, treatment was with docetaxel, epirubicin and cyclophosphamide. They were also randomly assigned to receive Avastin or not.

Overall, the odds of pathological complete response were increased by 29 percent with the addition of Avastin. However, when the researchers looked at tumors by hormone receptor status, they found that only women with triple-negative cancers had a significant response to Avastin. Having a triple-negative breast cancer means that a cancer's growth isn't influenced by hormones such as estrogen or progesterone. If a tumor is called hormone receptor-positive, it means that hormones, such as estrogen, can help fuel that cancer's growth.

In Bear's study, the investigators found Avastin had an effect on both hormone receptor-positive and hormone receptor-negati
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