Toxicity of locoregional radiotherapy in combination with bevacizumab in patients with non-metastatic breast cancer (TOLERAB): Final long-term evaluation.

BACKGROUND AND PURPOSE: Few data are available concerning the safety of bevacizumab (B) in combination with locoregional radiation therapy (RT). The objective of this study was to evaluate the 5-year late toxicity of concurrent B and RT in non-metastatic breast cancer. MATERIALS AND METHODS: This multicentre prospective study included non-metastatic breast cancer patients enrolled in phase 3 clinical trials evaluating B with concurrent RT versus RT alone. All patients received neoadjuvant or adjuvant chemotherapy and normofractionated breast or chest wall RT, with or without regional lymph node RT. B was administered at an equivalent dose of 5 mg/kg once a week for 1 year. The safety profile was evaluated 1, 3 and 5 years after completion of radiotherapy. RESULTS: A total of 64 patients were included between November 2007 and April 2010. Median follow-up was 60 months (12-73) and 5-year late toxicity data were available for 46 patients. The majority of tumours were triple-negative (68.8%), tumour size <2cm (41.3%) with negative nodal status (50.8%). Median total dose of B was 15,000mg and median duration was 11.2 months. No grade ≥3 toxicity was observed. Only 8 patients experienced grade 1-2 toxicities: n = 3 (6.5%) grade 1 lymphedema, n = 2 (4.3%) grade 1 pain, n = 1 (2.2%) grade 2 lymphedema, n = 1 (2.2%) grade 1 fibrosis. Five-year overall survival was 93.8%, disease-free survival was 89% and locoregional recurrence-free survival was 93.1%. CONCLUSION: Concurrent B and locoregional RT are associated with acceptable 5-year toxicity in patients with non-metastatic breast cancer. No grade ≥3 toxicity was observed.

[Pregnancy after breast cancer: A literature review]. / Grossesse après cancer du sein : revue de la littérature.

Pregnancies after breast cancer are still relatively rare observations. It was considered for a long time that a woman previously treated for a breast cancer could favour recurrence by becoming pregnant because of the hormonal impregnation. However, the improvement of the breast cancer treatments thanks to the improvement of the knowledge on this disease, allowed these women to envisage pregnancies after this disease. The current recommendations do not dissuade the pregnancy in case of complete cure. However, a pregnancy in this particular context arouses a number of questions such as the delay between the cancer and the pregnancy, the progress of these pregnancies, the oncologic and obstetric follow-up, the breast-feeding and its impact on breast cancer prognosis. The aim of this work is to answer these questions through a literature review.