Does Neoadjuvant Bevacizumab Increase Surgical Complications in Breast Surgery?

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• 作者：M. Golshan MD (1)
  J. E. Garber MD (2)
  R. Gelman PhD (2)
  Nadine Tung MD (3)
  B. L. Smith MD ; PhD (4)
  S. Troyan MD (1)
  C. C. Greenberg MD (1)
  E. P. Winer MD (2)
  P. Ryan MD ; PhD (5)
  
• 刊名：Annals of Surgical Oncology
• 出版年：2011
• 出版时间：March 2011
• 年：2011
• 卷：18
• 期：3
• 页码：733-737
• 全文大小：167KB
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• 作者单位：M. Golshan MD (1)
  J. E. Garber MD (2)
  R. Gelman PhD (2)
  Nadine Tung MD (3)
  B. L. Smith MD, PhD (4)
  S. Troyan MD (1)
  C. C. Greenberg MD (1)
  E. P. Winer MD (2)
  P. Ryan MD, PhD (5)
  
  1. Department of Surgery, Brigham and Women’s Hospital, Boston, MA, USA
  2. Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, USA
  3. Department of Medical Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA
  4. Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
  5. Department of Medical Oncology, Massachusetts General Hospital, Boston, MA, USA
  

文摘

Background Neoadjuvant chemotherapy is being increasingly used in operable breast cancer. There are limited data on the safety of bevacizumab (bev) in the neoadjuvant setting. We sought to explore the safety of neoadjuvant cisplatin/bev in a protocol for triple negative breast cancer (TNBC). Materials and Methods A total of 51 patients with confirmed TNBC were enrolled in a single-arm trial of neoadjuvant cisplatin plus bev. Of the 51 patients, 28 with confirmed TNBC were enrolled in our trial of single-agent neoadjuvant cisplatin. Two-sided Fisher exact test were used for comparing the 2 trials. Results The 51 patients received neoadjuvant protocol therapy with cisplatin/bev and underwent definitive local therapy. Breast conserving therapy (BCT) was performed in 29 (57%) and mastectomy with or without reconstruction in 22 (43%). Postoperative complications were reported in 22 patients (43%); 4 (8%) required explanation of expanders. Also, 28 patients completed neoadjuvant cisplatin therapy. BCT was performed in 13 (46%) and mastectomy with or without reconstruction in 15 (54%). Postoperative complications were reported in 11 patients (39%). None of the 5 reconstructions were lost. We compared all toxicities between the two trials (P?=?.81 NS), and wound healing related complications between the two trials (P?=?.10 NS). Conclusions Cisplatin/bevacizumab and cisplatin alone neoadjuvant therapy resulted in a significant number of postoperative complications. Specifically, use of expanders/implants may be problematic for patients treated with bev. However, this was a single-arm trial; randomized controlled studies will be needed to determine the optimal use of bevacizumab in the timing of breast cancer surgery.