Whole-Brain Radiotherapy Alone vs Preceded by Bevacizumab, Etoposide, and Cisplatin for Untreated Brain Metastases From Breast Cancer

作者：Tom Wei‐Wu Chen, Ming‐Shen Dai, Ling‐Ming Tseng, Shin‐Cheh Chen, Tsu‐Yi Chao, Ta‐Chung Chao, Yuan‐Ching Chang, Chang‐Fang Chiu, Chien-Ting Liu, Ching‐Hung Lin, Chun‐Yu Liu, Ya‐Fang Chen, Dwan‐Ying Chang, Jyh‐Cherng Yu, Kun‐Ming Rau, Yao‐Yu Hsieh, Shih‐Che Shen, Shu‐Min Huang, Ann‐Lii Cheng, Yen‐Shen Lu · 发表于：JAMA Oncology · 年份：2023 · DOI：10.1001/jamaoncol.2023.5456 · 被引用次数：28 · 研究领域：Brain Metastases and Treatment、Lung Cancer Research Studies、Lung Cancer Treatments and Mutations

Importance: The incidence of brain metastasis is increasing in patients with metastatic breast cancer. Treatments to extend the control of brain metastasis are urgently required. Objective: To investigate whether the addition of an induction treatment of bevacizumab, etoposide, and cisplatin (BEEP) improves brain-specific progression-free survival (PFS) after whole-brain radiotherapy (WBRT). Design, Setting, and Participants: This open-label, randomized, multicenter clinical trial assessed patients with brain metastases from breast cancer (BMBC) in Taiwan from September 9, 2014, to December 24, 2018, with survival follow-up until December 31, 2021. Key inclusion criteria included metastatic brain tumors not suitable for focal treatment, WBRT naivety, age 20 to 75 years, and at least 1 measurable brain metastatic lesion. The primary end point was brain-specific PFS, with an expected hazard ratio of 0.60, a 2-sided α ≤ .20, and power of 0.8. Interventions: Eligible patients were randomly assigned at a ratio of 2:1 to the experimental arm, which involved 3 cycles of BEEP followed by WBRT, or the control arm, which involved WBRT alone. Main Outcomes and Measures: The primary end point was the determination of brain-specific PFS by local investigators according to the Response Evaluation Criteria in Solid Tumors, version 1.1, the initiation of other brain-directed treatment after WBRT, or death. Other key end points included brain-specific objective response rate after 8 weeks of ...