| 基本情報/Basic information |
| 一般向け試験名/Public title |
HER2陰性転移乳癌の1次化学療法としてのベバシズマブとパクリタキセル併用療法の安全性と有効性を検討した前向き観察研究の統合解析 |
Pooled-analysis of prospective observational studies evaluated the efficacy and safety of bevacizumab(BEV) and paclitaxel(PTX) as the first-line chemotherapy for HER2-negative metastatic breast cancer(MBC). |
| 一般向け試験名略称/Acronym |
転移乳癌に対するベバシズマブ前向き観察研究の統合解析 |
Pooled analysis of prospective bevacizumab observational studies for metastatic breast cancer |
| 科学的試験名/Scientific Title |
HER2陰性転移乳癌の1次化学療法としてのベバシズマブとパクリタキセル併用療法の安全性と有効性を検討した前向き観察研究の統合解析 |
Pooled-analysis of prospective observational studies evaluated the efficacy and safety of bevacizumab(BEV) and paclitaxel(PTX) as the first-line chemotherapy for HER2-negative metastatic breast cancer(MBC). |
| 科学的試験名略称/Scientific Title:Acronym |
転移乳癌に対するベバシズマブ前向き観察研究の統合解析 |
Pooled analysis of prospective bevacizumab observational studies for metastatic breast cancer |
| 試験実施地域/Region |
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| 介入/Intervention |
| 群数/No. of arms |
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| 介入の目的/Purpose of intervention |
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| 介入の種類/Type of intervention |
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| 介入1/Interventions/Control_1 |
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| 介入2/Interventions/Control_2 |
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| 介入3/Interventions/Control_3 |
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| 介入4/Interventions/Control_4 |
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| 介入5/Interventions/Control_5 |
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| 介入6/Interventions/Control_6 |
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| 介入7/Interventions/Control_7 |
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| 介入8/Interventions/Control_8 |
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| 介入9/Interventions/Control_9 |
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| 介入10/Interventions/Control_10 |
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| 適格性/Eligibility |
| 年齢(下限)/Age-lower limit |
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| 年齢(上限)/Age-upper limit |
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| 性別/Gender |
男女両方/Male and Female |
| 選択基準/Key inclusion criteria |
各試験の選択基準(B-SHARE,ML21165,AVAREG, AVANTI) |
Key inclusion criteria in each study (B-SHARE,ML21165,AVAREG,AVANTI) |
| 除外基準/Key exclusion criteria |
各試験の除外基準(B-SHARE,ML21165,AVAREG, AVANTI) |
Key exclusion criteria in each study (B-SHARE,ML21165,AVAREG,AVANTI) |
| 目標参加者数/Target sample size |
2500 |
| 結果/Result |
| 結果掲載URL/URL related to results and publications |
https://jbcrg.jp/clinicaltrials/679/ |
| 組み入れ参加者数/Number of participants that the trial has enrolled |
2474 |
| 主な結果/Results |
観察期間の中央値は10.9ヶ月。全生存期間の中央値は21.4ヶ月(95%信頼区間 19.8-22.7ヶ月)。全生存期間に関する7つの独立した予後因子を同定した(腫瘍サブタイプ、年齢、ECOG PS、無病生存期間、肝転移、転移臓器数、周術期のアンスラサイクリン/タキサンの使用)。このリスク因子3つ以上を有する高PIおよびリスク因子2つを有する中間PIの腫瘍は、リスク因子1以下の低PIと比較して有意に予後不良であった。 |
The median OS was 21.4 M
7 independent prognostic factors for OS were identified (tumor subtype, age, ECOG PS, DFI, liver metastasis, number of metastatic organs, prior anthracycline or taxane treatment). |
| 主な結果入力日/Results date posted |
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| 結果掲載遅延/Results Delayed |
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| 結果遅延理由/Results Delay Reason |
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| 最初の試験結果の出版日/Date of the first journal publication of results |
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| 参加者背景/Baseline Characteristics |
年齢中央値59歳。ECOG PS 2以上が8.3%、ホルモン受容体陽性73.0%, トリプルネガティブ 22.0%,サブタイプ不明5.0%。DFI24ヶ月以下16.7%。内臓転移74.5%、3臓器以上の転移18.6%、肝転移41.6%,肺転移38.0%、骨転移54.7%。周術期化学療法例56.7%, そのうちアンスラサイクリン/タキサン使用例88.4% |
Median age 59 years old.
ECOG performance status 2 or above was 201 (8.3%).
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| 参加者の流れ/Participant flow |
4つの前向き観察研究より2902人が参加。このうちHER2陰性2474例を本解析に用いた。1次治療としてベバシズマブ+パクリタキセルを使用しなかった279例、局所進行乳癌および局所再発184例、その他不適格13例を除外した。 |
From the four prospective observational studies, 2902 patients were included in dataset for this pooled analysis. Among them, 2474 HER2-negative metastatic breast cancer patients were used in this pooled analysis, excluding patients not receiving bevacizumab plus paclitaxel as first-line chemotherapy (n=279), locally advanced or local recurrent breast cancer without distant metastasis (n=184), and patients with other reason for ineligibility (n=13) |
| 有害事象/Adverse events |
高血圧 25.2%,出血 19.5%, タンパク尿18.6%、好中球減少 17.0%、末梢神経障害 14.1%、血栓塞栓症1.6%,消化管せん孔 0.2%、心不全0.2% |
Hypertension 25.2%, Hemorrhage 19.5%, Proteinuria 18.6%, Neutropenia 17.0%, Peripheral neuropathy 14.1%, Thromboembolism 1.6%, Gastrointestinal perforation 0.2%, Cardiac failure 0.2% |
| 評価項目/Outcome measures |
OS中央値 全例21.4 M、ホルモン受容体陽性23.6 M、トリプルネガティブ 15.8 M。
OSに関する7つの独立した予後因子を同定(サブタイプ, 年齢, ECOG PS, DFI, 肝転移, 転移臓器数, アンスラサイクリン、タキサン治療歴)
ATHENA試験のPFIを検証した。 |
The median OS was 21.4, 95% confidence interval 19.8 to 22.7M.
The seven independent prognostic factors (tumor subtype, age, Eastern Cooperative Oncology Group [ECOG] performance status [PS], disease-free interval [DFI], liver metastases, number of metastatic organs, and prior anthracycline or taxane treatment) for OS found in this analysis included five risk factors (RFs; DFI <24 M, ECOG PS 2, and/or >3 metastatic organ sites, triple-negative breast cancer, and prior anthracycline and/or taxane therapy). High- (>3 RFs; median OS: 12.6 M) and intermediate-risk groups (2 RFs; median OS: 18.0 M) had significantly worse prognosis than the low-risk group (<1 RF; median OS: 27.4 M; P<0.0001). |
| 個別症例データ共有計画/Plan to share IPD |
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| 個別症例データ共有計画の詳細/IPD sharing Plan description |
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