Systemic Therapy for Metastatic Disease
Have you used bevacizumab for metastatic breast cancer off protocol?
Have you used bevacizumab for metastatic breast cancer off protocol?
Have you used bevacizumab for metastatic breast cancer off protocol?
Have you used bevacizumab for metastatic breast cancer off protocol?
Have you used bevacizumab for metastatic breast cancer off protocol?
Cost and reimbursement issues aside, bevacizumab should generally be used in a clinical setting only when initiating first-line paclitaxel for metastatic disease.
Cost and reimbursement issues aside, bevacizumab should generally be used in a clinical setting only when first-line chemotherapy is being initiated for metastatic disease.
Patients with metastatic disease experiencing prolonged useful responses to bevacizumab with chemotherapy should be presented with the option of continuing bevacizumab and switching to another chemotherapy.
Have you used Harold Burstein’s metronomic regimen of bevacizumab, cyclophosphamide and methotrexate?
Have you used endocrine therapy in combination with bevacizumab?
A significant component of the antitumor effect of bevacizumab in breast cancer is the improved delivery of cytotoxics to tumor cells.
A 60-year-old woman with an ER-negative, PR-negative, HER2-negative tumor experiences relapse after adjuvant AC. She is treated with paclitaxel/bevacizumab and has a near-complete response in her liver and lung, but then her disease progresses at 18 months. What would you recommend?
For patients with ER-negative, PR-negative, HER2-negative tumors, the following bevacizumab therapy combinations are acceptable in the first-line setting
For patients with ER-negative, PR-negative, HER2-negative tumors, the following bevacizumab therapy combinations are acceptable in the first-line setting
For patients with ER-negative, PR-negative, HER2-negative tumors, the following bevacizumab therapy combinations are acceptable in the first-line setting
For a patient who presents with asymptomatic metastatic disease and
no prior systemic therapy
, how would you compare the following agents/regimens?
For a patient who presents with asymptomatic metastatic disease and
no prior systemic therapy
, how would you compare the following agents/regimens?
For a patient who presents with asymptomatic metastatic disease and
no prior systemic therapy
, how would you compare the following agents/regimens?
For a patient who presents with asymptomatic metastatic disease and
no prior systemic therapy
, how would you compare the following agents/regimens?
For a patient who presents with asymptomatic metastatic disease and
no prior systemic therapy
, how would you compare the following agents/regimens?
For a patient who presents with asymptomatic metastatic disease and
no prior systemic therapy
, how would you compare the following agents/regimens?
For a patient who presents with asymptomatic metastatic disease and
no prior systemic therapy
, how would you compare the following agents/regimens?
For a patient who presents with asymptomatic metastatic disease and
no prior systemic therapy
, how would you compare the following agents/regimens?
For a patient who presents with asymptomatic metastatic disease and
no prior systemic therapy
, how would you compare the following agents/regimens?
For a patient who presents with asymptomatic metastatic disease and
no prior systemic therapy
, how would you compare the following agents/regimens?
A
60-year-old woman
was diagnosed three years earlier with
ER-negative
,
PR-negative
,
HER2-negative
breast cancer and received AC. She now has moderately symptomatic bone metastases and no other sites of disease on staging. Which therapy would you recommend for this patient?
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From a convenience perspective, what percentage of your patients with metastatic breast cancer in your practice would prefer to receive a monthly injection of fulvestrant rather than a daily oral endocrine agent such as an aromatase inhibitor or tamoxifen?
One acceptable clinical option for patients with ER-positive tumors who develop progressive metastatic disease on an aromatase inhibitor (AI) is to continue the AI and add fulvestrant.
In a clinical setting, a loading dose of fulvestrant should generally be used if financially feasible.
A
60-year-old woman
was diagnosed three years earlier with
ER-positive
,
PR-positive
,
HER2-negative
breast cancer and received AC followed by anastrozole. Currently receiving anastrozole, she now has moderately symptomatic bone metastases and no other sites of disease on staging. Which therapy would you recommend to this patient?
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