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Chemotherapy plus bevacizumab extends survival in epithelial ovarian cancer
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The addition of chemotherapy to bevacizumab improved survival among women with recurrent, heavily pretreated epithelial ovarian cancer, according to a multicenter analysis.
Single-agent chemotherapy is the standard treatment for epithelial ovarian cancer, the most lethal pelvic gynecologic malignancy. Clinicians are more apt to suggest single-agent treatment due to the potential for increased toxicities with combined therapies, as well as the scarcity of efficacy data of combined therapies in this setting.
John K. Chan, MD, director of gynecologic oncology and a specialist in the surgical and medical treatment of ovarian and other complex pelvic cancers at University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, and colleagues evaluated whether the addition of chemotherapy to bevacizumab (Avastin, Genentech) influenced survival among women with recurrent, heavily pretreated disease.
The investigators retrospectively analyzed 277 patients (median age, 58 years) treated from 2004 to 2011. PFS and OS served as primary endpoints.
The majority of patients had stage III or stage IV disease (86%) and had serous histology (72%).
From this cohort, 88% received chemotherapy plus bevacizumab, whereas 12% received bevacizumab alone.
Researchers reported longer median PFS (8.7 months vs. 6.7 months; P = .01) and longer median OS (14.3 months vs. 10.5 months; P < .01) among patients assigned the combination.
The researchers also stratified outcomes by type of chemotherapy used. The most common type was gemcitabine (43.5%), followed by taxanes (22.5%), topotecan (17.6%), cyclophosphamide (8.6%) and pegylated liposomal doxorubicin (7.8%).
Results showed those who received pegylated liposomal doxorubicin experienced the longest median OS (20.4 months), followed by taxanes (20.2 months), gemcitabine (14.1 months), topotecan (13 months) and cyclophosphamide (13 months).
Chan and colleagues reported no significant difference in toxicities between the combination regimen and bevacizumab monotherapy.
The investigators acknowledged several limitations to their study. They included the retrospective design and the lack of standardization of treatment, which created an imbalance in the sample size in each study arm.
“Despite these [and other] limitations, our data suggest that combination chemotherapy and bevacizumab may result in improved response and survival outcomes with a tolerable general safety profile compared to bevacizumab alone,” the researchers wrote. – by Anthony SanFilippo
Disclosure: The researchers report no relevant financial disclosures.
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