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Here, we report on a randomized phase II clinical trial to study the added effect of bevacizumab in neoadjuvant chemotherapy with FEC100 (5\u2010fluorouracil, epirubicin and cyclophosphamide) and taxanes (<jats:italic>n<\/jats:italic> = 132 patients). Gene expression from the tumors was obtained before neoadjuvant treatment, and treatment response was evaluated by residual cancer burden (RCB) at time of surgery. Bevacizumab increased the proportion of complete responders (RCB class 0) from 5% to 20% among patients with estrogen receptor (ER) positive tumors (<jats:italic>P<\/jats:italic> = .02). Treatment with bevacizumab was associated with improved 8\u2010year disease\u2010free survival (<jats:italic>P<\/jats:italic> = .03) among the good responders (RCB class 0 or I). Patients treated with paclitaxel (<jats:italic>n<\/jats:italic> = 45) responded better than those treated with docetaxel (<jats:italic>n<\/jats:italic> = 21; <jats:italic>P<\/jats:italic> = .03). Improved treatment response was associated with higher proliferation rate and an immune phenotype characterized by high presence of classically activated M1 macrophages, activated NK cells and memory activated CD4 T cells. Treatment with bevacizumab increased the number of adverse events, including hemorrhage, hypertension, infection and febrile neutropenia, but despite this, the ECOG status was not affected.<\/jats:p>","DOI":"10.1002\/ijc.33108","type":"journal-article","created":{"date-parts":[[2020,6,3]],"date-time":"2020-06-03T07:43:47Z","timestamp":1591170227000},"page":"2515-2525","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Immune phenotype of tumor microenvironment predicts response to bevacizumab in neoadjuvant treatment of <scp>ER<\/scp>\u2010positive breast cancer"],"prefix":"10.1002","volume":"147","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1870-6402","authenticated-orcid":false,"given":"Hedda","family":"von der Lippe Gythfeldt","sequence":"first","affiliation":[{"name":"Department of Cancer Genetics, Institute for Cancer Research Oslo University Hospital  Oslo Norway"},{"name":"Department of Oncology Oslo 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