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A case series of low dose bevacizumab and chemotherapy in heavily pretreated patients with epithelial ovarian cancer
Abstract
Background
The addition of bevacizumab to standard chemotherapy prolongs progression free survival in the first line treatment of epithelial
ovarian cancer (EOC), but its cost/effectiveness is debated. We assessed the safety and activity of a lower dose of bevacizumab
in pretreated advanced stage EOC.
ovarian cancer (EOC), but its cost/effectiveness is debated. We assessed the safety and activity of a lower dose of bevacizumab
in pretreated advanced stage EOC.
Methods
We treated 15 patients, mostly with platinum resistant EOC, who had received a median of four prior cytotoxic regimens, with
bevacizumab 5–7.5 mg/kg q21 days in combination with either carboplatin (n = 8), oral cyclofosfamide (n = 5) or weekly paclitaxel
(n = 2). Bevacizumab was administered until disease progression. Tumor response was assessed by CA125 and fusion 18 F-FDG PET/contrast enhanced CT.
bevacizumab 5–7.5 mg/kg q21 days in combination with either carboplatin (n = 8), oral cyclofosfamide (n = 5) or weekly paclitaxel
(n = 2). Bevacizumab was administered until disease progression. Tumor response was assessed by CA125 and fusion 18 F-FDG PET/contrast enhanced CT.
Results
The median number of bevacizumab cycles was 21 (range 3–59). The median baseline CA125 was 272 U/ml and decreased to 15.2
U/ml at nadir. Tumor response was 4 complete response (CR) (26.7%) and 7 partial response (PR) (46.7%) by chemotherapy (CT),
with an overall response rate of 73.4% (95% CI, 51.0 – 95.8) according to Response Evaluation Criteria In Solid Tumors (RECIST),
and 6 CR (40%) and 4 PR (26.7%) by PET, for an overall metabolic response rate of 67% (95%CI, 42.8 – 90.6) according to PET
Response Criteria in Solid Tumors (PERCIST). Median progression free survival (PFS) was 21 months and median overall survival
(OS) was 24 months. Grade 3 adverse events related to bevacizumab were hypertension (n = 2), proteinuria (n = 1) and epistaxis
(n = 5). Treatment was delayed in five patients for nasal bleeding or uncontrolled hypertension.
U/ml at nadir. Tumor response was 4 complete response (CR) (26.7%) and 7 partial response (PR) (46.7%) by chemotherapy (CT),
with an overall response rate of 73.4% (95% CI, 51.0 – 95.8) according to Response Evaluation Criteria In Solid Tumors (RECIST),
and 6 CR (40%) and 4 PR (26.7%) by PET, for an overall metabolic response rate of 67% (95%CI, 42.8 – 90.6) according to PET
Response Criteria in Solid Tumors (PERCIST). Median progression free survival (PFS) was 21 months and median overall survival
(OS) was 24 months. Grade 3 adverse events related to bevacizumab were hypertension (n = 2), proteinuria (n = 1) and epistaxis
(n = 5). Treatment was delayed in five patients for nasal bleeding or uncontrolled hypertension.
Conclusions
Low-dose bevacizumab and chemotherapy was well tolerated and active in a heavily pretreated population of advanced EOC. Further
studies should assess the activity of low dose bevacizumab in EOC.
studies should assess the activity of low dose bevacizumab in EOC.
- Content Type Journal Article
- Category Research
- Pages 1-7
- DOI 10.1186/1757-2215-5-17
- Authors
- Defferrari Carlotta, Unit of Medical Oncology, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16128 Genoa, Italy
- Campora Sara, Unit of Medical Oncology, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16128 Genoa, Italy
- D'Amico Mauro, Unit of Medical Oncology, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16128 Genoa, Italy
- Piccardo Arnoldo, Nuclear Medicine, E.O. Ospedali Galliera, Genoa, Italy
- Biscaldi Ennio, Radiology, E.O. Ospedali Galliera, Genoa, Italy
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