Efficacy and safety of bevacizumab combined with capecitabine in the treatment of advanced breast cancer

doi:10.3760/cma.j.cn371439-20230116-00029

Abstract

Abstract:

Objective To investigate the efficacy and safety of bevacizumab combined with capecitabine in the treatment of advanced breast cancer. Methods Seventy-six patients with advanced breast cancer who were diagnosed in the Cancer Center of the People's Liberation Army Navy Anqing Hospital from August 2019 to May 2021 were selected. According to different treatment schemes， the patients were divided into the control group （using single drug capecitabine） and the test group （using bevacizumab combined with capecitabine）， with 38 cases in each group. After 4 cycles of treatment， the clinical efficacy， progression-free survival （PFS）， overall survival （OS） and adverse reactions were compared between the two groups， and the levels of vascular endothelial growth factor （VEGF）-121， VEGF-145， VEGF-165 and quality of life before and after treatment were compared. Results The objective remission rate of the test group [57.89% （22/38）] was higher than that of the control group [42.11% （16/38）]， but there was no statistically significant difference （χ²=1.89， P=0.169）； The disease control rate of the test group [81.58% （31/38）] was better than that of the control group [55.26% （21/38）]， there was a statistically significant difference （χ²=6.09，P=0.014）. The median PFS of patients in the test group （6.3 months） was longer than that in the control group （4.2 months）， there was a statistically significant difference （χ²=0.48， P=0.003）； The median OS of patients in the test group （14.8 months） was not significantly different from that in the control group （13.2 months）（χ²=0.15， P=0.704）. After treatment， the expression level of serum VEGF-121 [（201.25±18.37） ng/L vs. （276.83±20.26） ng/L]， VEGF-145 [（102.24±12.16） ng/L vs. （170.39±15.28） ng/L]， VEGF-165 [（135.08±14.32） ng/L vs. （210.53±16.09） ng/L] in the test group was lower than that in the control group， there were statistically significant differences （t=17.03， P<0.001； t=21.51， P<0.001； t=21.59， P<0.001）. After treatment， patients in the test group were assessed according to 36-item Short-Form （SF-36） physiological function [（80.18±13.96） score vs. （71.72±16.12） score]， physiological function [（67.19±30.62） score vs. （53.12±9.86） score]， physical pain [（70.01±17.97） score vs. （61.06±17.57） score]， overall health [（68.67±18.92） score vs. （57.96±20.97） score]， vitality [（78.39±19.37） score vs. （68.26±18.52） score]， social function [（82.24±19.73） score vs. （70.92±20.31） score]， the scores of emotional function [（73.81±28.86） score vs. （60.23±29.19） score] and mental health [（76.19±12.82） score vs. （70.31±12.54） score] were higher than those of the control group， there were statistically significant differences （t=2.45， P=0.017； t=2.03， P=0.046； t=2.19， P=0.031； t=2.34， P=0.022； t=2.33， P=0.023； t=2.46， P=0.016； t=2.04， P=0.045； t=2.02， P=0.047）. The incidence of adverse reactions in the test group [18.42% （7/38）] was lower than that in the control group [76.32% （29/38）]， there was a statistically significant difference （χ²=25.54， P<0.001）. Conclusion The combination of bevacizumab and capecitabine chemotherapy has a higher clinical effect on advanced breast cancer， which can significantly reduce the level of VEGF in patients， improve the quality of life of patients， with mild adverse reactions and high safety.

Key words: Breast neoplasms, Treatment outcome, Drug-related side effects and adverse reactions, Bevaczumab, Kapitabin

Zhou Ting, Xu Shaohua, Mei Lin. Efficacy and safety of bevacizumab combined with capecitabine in the treatment of advanced breast cancer[J]. Journal of International Oncology, 2023, 50(3): 144-149.

Figures/Tables 7

References 15

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临床特征	试验组（n=38）	对照组（n=38）	t/χ²/Z值	P值
年龄（岁）	59.37±11.28	60.15±12.08	0.29	0.772
转移情况
单个部位	16（42.11）	19（50.00）	0.48	0.490
两个及以上	22（57.89）	19（50.00）	0.48	0.490
肿瘤分期
Ⅱ期	5（10.53）	4（40.53）
Ⅲ期	28（73.68）	26（68.42）	0.13	0.723
Ⅳ期	5（10.53）	8（21.05）

组别	CR	PR	SD	PD	客观缓解	疾病控制
试验组（n=38）	12（31.58）	10（26.32）	9（23.38）	7（18.42）	22（57.89）	31（81.58）
对照组（n=38）	7（18.42）	9（23.38）	5（13.16）	17（44.74）	16（42.11）	21（55.26）
χ²值					1.89	6.09
P值					0.169	0.014

组别	VEGF-121		VEGF-145		VEGF-165
组别	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
试验组（n=38）	325.16±22.92	201.25±18.37^a	223.07±19.14	102.24±12.16^a	263.95±18.86	135.08±14.32^a
对照组（n=38）	323.05±22.18	276.83±20.26^a	221.64±18.36	170.39±15.28^a	265.16±19.58	210.53±16.09^a
t值	0.41	17.03	0.33	21.51	0.27	21.59
P值	0.685	<0.001	0.741	<0.001	0.785	<0.001

组别	生理功能		生理职能		躯体疼痛		总体健康
组别	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
试验组（n=38）	58.25±18.34	80.18±13.96^a	42.25±7.63	67.19±30.62^a	55.85±20.34	70.01±17.97^a	41.12±5.83	68.67±18.92^a
对照组（n=38）	58.62±17.98	71.72±16.12^a	39.32±4.65	53.12±9.86^a	55.38±20.51	61.06±17.57^a	40.96±6.39	57.96±20.97^a
t值	0.09	2.45	0.49	2.03	0.10	2.19	0.03	2.34
P值	0.929	0.017	0.624	0.046	0.920	0.031	0.974	0.022
组别	活力		社会功能		情感职能		精神健康
组别	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
试验组（n=38）	53.91±18.39	78.39±19.37^a	61.59±21.08	82.24±19.73^a	39.96±3.94	73.81±28.86^a	59.57±13.99	76.19±12.82^a
对照组（n=38）	54.18±19.18	68.26±18.52^a	61.37±20.83	70.92±20.31^a	40.18±6.67	60.23±29.19^a	59.42±14.08	70.31±12.54^a
t值	0.06	2.33	0.05	2.46	0.12	2.04	0.05	2.02
P值	0.950	0.023	0.964	0.016	0.906	0.045	0.963	0.047

组别	胸闷	高血压	恶心	发热	呕吐、腹泻	合计
试验组（n=38）	2（5.26）	0（0）	3（7.89）	1（2.63）	1（2.63）	7（18.42）
对照组（n=38）	8（21.05）	3（7.89）	10（26.32）	3（7.89）	5（13.16）	29（76.32）
χ²值						25.54
P值						<0.001