Standard chemotherapy with or without bevacizumab for women with newly diagnosed ovarian cancer (ICON7): phase 3l

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 Standard chemotherapy with or without bevacizumab for women with newly diagnosed ovarian cancer (ICON7): overall survival results of a phase 3 randomised trial

Published online June 24, 2015

Background

The ICON7 trial previously reported improved progression-free survival in women with ovarian cancer with the addition of bevacizumab to standard chemotherapy, with the greatest effect in patients at high risk of disease progression. We report the final overall survival results of the trial.

 Interpretation

 Bevacizumab, added to platinum-based chemotherapy, did not increase overall survival in the study population as a whole. However, an overall survival benefit was recorded in poor-prognosis patients, which is concordant with the progression-free survival results from ICON7 and GOG-218, and provides further evidence  towards the optimum use of bevacizumab in the treatment of ovarian cancer.

Comment
.....Although the results of ICON7 offer the tantalising possibility that a patient subgroup might derive an overall survival benefit from first-line bevacizumab, caution should be exercised when interpreting subset analyses, and additional questions remain unanswered regarding the use of bevacizumab in newly diagnosed ovarian cancer. Only a small proportion of patients in ICON7 received bevacizumab after disease recurrence, and therefore whether or not bevacizumab use in the recurrent setting could off set the overall survival benefits recorded in this high-risk population remains unknown. Additional studies to understand the effect of subsequent bevacizumab treatment on survival and to further identify and validate molecular markers of anti- angiogenic response will be important to better define our understanding of the role of bevacizumab therapy inovarian cancer.