Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Jun 25;5(1):17.
doi: 10.1186/1757-2215-5-17.

A case series of low dose bevacizumab and chemotherapy in heavily pretreated patients with epithelial ovarian cancer

Carlotta Defferrari  1 , Sara Campora, Mauro D'Amico, Arnoldo Piccardo, Ennio Biscaldi, Daniela Rosselli, Ambra Pasa, Matteo Puntoni, Alberto Gozza, Alessandra Gennari, Silvia Zanardi, Rita Lionetto, Michela Bandelloni, Andrea Decensi
Affiliations

A case series of low dose bevacizumab and chemotherapy in heavily pretreated patients with epithelial ovarian cancer

Carlotta Defferrari et al. J Ovarian Res. .

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.

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.

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.

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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Waterfall plot of best Ca125 response.
Figure 2
Figure 2
Peritoneal metastasis from ovarian cancer close to the ascending colon detected by18 F-FDG PET/Contrast enhanced (Ce)CT before starting bevacizumab (A) and at best response (B).
Figure 3
Figure 3
Peritoneal carcinomatosis from ovarian cancer detected by18 F-FDG PET/Contrast enhanced (Ce)CT before starting bevacizumab (A) and at best response (B).
Figure 4
Figure 4
Kaplan-Meier progression-free survival (A, top panel) and overall survival (B, bottom panel).
See this image and copyright information in PMC

References

    1. Ma WW, Adjei AA. Novel agents on the horizon for cancer therapy. CA Cancer J Lin. 2009;59:111–137. doi: 10.3322/caac.20003. - DOI - PubMed
    1. Folkman J. Tumor angiogenesis: therapeutic implications. N Engl J Med. 1971;285:1182–1186. doi: 10.1056/NEJM197111182852108. - DOI - PubMed
    1. Hiclin DJ, Ellis LM. Role of the vascular endothelial growth factor pathway in tumor growth and angiogenesis. J Clin Oncol. 2005;23:1011–1027. - PubMed
    1. Ishigami SI, Arii S, Furutani M, Niwano M, Harada T, Mizumoto M, Mori A, Onodera H, Imamura M. Predictive value of vascular endothelial growth factor (VEGFR) in metastasis and prognosis of human colorectal cancer. Br J Cancer. 1998;78:1379–1384. doi: 10.1038/bjc.1998.688. - DOI - PMC - PubMed
    1. Shimogai R, Kigawa J, Itamochi H, Iba T, Kanamori Y, Oishi T, Shimada M, Sato S, Kawaguchi W, Sato S, Terakawa N. Expression of hypoxia-inducible factor 1alha gene affects the outcome in patients with ovarian cancer. Int J Gynecol Cancer. 2008;18:499–505. doi: 10.1111/j.1525-1438.2007.01055.x. - DOI - PubMed