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abstract:
Feasibility and outcome of interval debulking surgery (IDS) after carboplatin-paclitaxel-bevacizumab (CPB): A subgroup analysis of the MITO-16A-MaNGO OV2A phase 4 trial
Highlights
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- 20% of patients underwent IDS in a large non-randomized trial, in Italy.
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- 86.5% of the patients had residual disease ≤ 1 cm and 63.5% had no residual.
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- 27 patients (38%) had the intervention complicated by, at least, one adverse event.
Background
Few
data are available on the outcome of surgery after a
bevacizumab-containing regimen. The MITO 16A- MaNGO OV2A phase 4 trial
evaluates the outcomes of first-line CPB in a clinical-practice-like
setting. Here we present the results of the subgroup of patients
undergoing IDS after neoadjuvant treatment or suboptimal primary
surgery.
Methods
400 chemonaïve
epithelial ovarian cancer patients, age ≥ 18, ECOG PS 0–2 were eligible
to receive C (AUC 5 d1, q21) plus P (175 mg/m2 d1, q21) and B (15 mg/kg d1 q21) for 6 cycles followed by B maintenance until cycle 22nd.
Results
79
patients (20%) underwent IDS. Overall, 74 patients received at least
one administration of B before IDS. Median age was 61.2, 70% of the
patients had FIGO IIIC disease. The median number of cycles before IDS
was 3 both for chemotherapy and bevacizumab respectively. A residual
disease ≤ 1 cm was achieved in 64 patients (86.5%). Four percent of the
patients experienced fever and 4% required blood transfusion after
surgery. Surgical wound infection and/or dehiscence, pelvic abscess,
intestinal sub-occlusion and fistula were experienced by one patient
each.
Conclusions
In the
MITO16A-MaNGO OV2A phase 4 trial, combined chemotherapy and bevacizumab
did not hamper IDS and the rate of perioperative complications was
similar to what expected without bevacizumab. These data support the
hypothesis that adding bevacizumab to first line chemotherapy for
ovarian cancer might not be denied to patients for whom IDS is planned.
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