This prospective, phase II study evaluated novel biomarkers as predictors of response to bevacizumab in patients with breast cancer (BC), using serial imaging methods and gene expression analysis. Patients with primary stage II/III BC received bevacizumab 15 mg/kg (cycle 1; C1), then four cycles of neoadjuvant docetaxel doxorubicin, and bevacizumab every 3 weeks (C2–C5). Tumour proliferation and hypoxic status were evaluated using ¹⁸F-fluoro-3′-deoxy-3′-L-fluorothymidine (FLT)- and ¹⁸F-fluoromisonidazole (FMISO)-positron emission tomography (PET) at baseline, and during C1 and C5. Pre- and post-bevacizumab vascular changes were evaluated using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Molecular biomarkers were assessed using microarray analysis. A total of 70 patients were assessed for treatment efficacy. Significant decreases from baseline in tumour proliferation (FLT-PET), vascularity, and perfusion (DCE-MRI) were observed during C1 (p ≤ 0.001), independent of tumour subtype. Bevacizumab treatment did not affect hypoxic tumour status (FMISO-PET). Significant changes in the expression of 28 genes were observed after C1. Changes in vascular endothelial growth factor receptor (VEGFR)-2p levels were observed in 65 patients, with a > 20% decrease in VEGFR-2p observed in 13/65. Serial imaging techniques and molecular gene profiling identified several potentially predictive biomarkers that may predict response to neoadjuvant bevacizumab therapy in BC patients.

Background; Maintaining good Quality of Life (QOL) in elderly long-term breast cancer survivors (LTBCS) is a major challenge today. Identifying particularly affected areas and associated factors can help to optimally organise the health care provided. Methods: A total of 316 elderly (>70 years) stage I-IIIA LTBCS subjected to breast surgery >5 years ear-lier completed EORTC QLQ-C30, QLQ-BR42 and QLQ-ELD14 on two occasions in the same year. QOL scores and their one-year evolution were described and their relation to demographic and clinical characteristics was assessed using non-parametric tests. De-terminants of elderly-specific key aspects of QOL were also explored with linear regres-sion models. Results: QOL scores were high (>80/100 points) in most areas. Limitations were moderate (>30 points) in sexual functioning/enjoyment, skeletal symptoms and three elderly-specific scales. QOL differences between the two assessments were few and trivial. The >75 years group showed lower QOL than the < 75 years group in nine QLQ-C30 and four QLQ-ELD14 areas. Patients younger at treatment, living with a partner and without limiting comorbidity showed better QOL. Combinations of lower symptoms and higher functioning with cohabitation and clinical variables were related to the two QLQ-ELD14 scales. Conclusions: High QOL in elderly early-stage LTBCS indicated that patients adapted well to their situation. These results, relevant due to the high age of our partici-pants, indicate areas for improvement.