الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Patients with TNBC constitute a well-known subgroup with a poor prognosis. In the meantime, in the absence of validated biomarkers, the clinical risk factors that currently constitute the other main component of the treatment decision-making algorithm play a key role in deciding whether chemotherapy is indicated and therefore whether bevacizumab has to be added. The clinical factors that define the aggressiveness of the disease include, but are not limited to, symptomatic disease, visceral metastasis (liver, lung, and central nervous system), rapidly progressive disease, premature relapse, and a short disease-free intervalSo that TNBC is an interesting area of research and new insights should be taken in consideration as molecular subtypes, clinical patient characteristics and validated biomarkers for bevacizumab efficacy. In our study bevacizumab was well tolerated combined with carboplatin and paclitaxel every 3 weeks with less AE and we recommend to continue it as maintenance therapy as long as clinical response either SD or CR is obtained as it was clearly affects survival. Also, identifying patients characteristics base line before starting bevacizumab has a vital role in predicting response to prevent financial loss and patients harm. Notably, integration of a potential marker to predict response to bevacizumab in trials should be encouraged. For example, plasma vascular endothelial growth factor A is currently being evaluated in the meridian trial) and the angiotensin ii receptor type 1 has also recently been hypothesized in trials waiting results. Genetic testing for BRCA1/2 mutations, although strongly recommended for patients with TNBC before starting platinum agents. So our recommendation for a more comprehensive and accurate under standing of the value of bevacizumab to expand the number of included randomized controlled trials (RCTs) and perform a systematic assessment to analyze the efficacy and safety of BEV combined with ChT compared to ChT alone. The main limitations of the current study are the relatively small sample size, the lack of a control arm (phase II data), the absence of information regarding BRCA1/2 mutation status, and subsequent treatment for all patients after the discontinuation of study therapy. However, without a control arm, such comparisons provide the only guidance in interpretation of the findings of the current study within the context of other treatment options in this setting.