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. 2022 Apr;27(4):790-801.
doi: 10.1007/s10147-021-02103-7. Epub 2022 Jan 5.

Platinum rechallenge treatment using gemcitabine plus carboplatin with or without bevacizumab for platinum-resistant ovarian cancer

Hiroki Nasu  1 , Shin Nishio  2 , Jongmyung Park  2 , Teruyuki Yoshimitsu  2 , Ken Matsukuma  2 , Kazuto Tasaki  2 , Takahiro Katsuda  2 , Atsumu Terada  2 , Naotake Tsuda  2 , Kimio Ushijima  2
Affiliations

Platinum rechallenge treatment using gemcitabine plus carboplatin with or without bevacizumab for platinum-resistant ovarian cancer

Hiroki Nasu et al. Int J Clin Oncol. 2022 Apr.

Abstract

Purpose: Platinum-resistant ovarian cancer (PROC) is usually treated with single-agent chemotherapy. A synergistic effect of gemcitabine and platinum has been reported in PROC. We evaluated the efficacy and safety of gemcitabine and carboplatin with or without bevacizumab (GC ± B) in patients with PROC.

Methods: From April 2014 to April 2018, patients with PROC received gemcitabine on days 1 and 8, and carboplatin on day 1, with or without bevacizumab (Bev) on day 1 every 3 weeks. The primary endpoint was objective response rate (ORR). The secondary endpoints were disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and rate of adverse events.

Results: In total, 215 cycles were administered to 31 patients, of whom 21 received Bev and the median number of cycle for each patient was 6 (range, 2-19). The median platinum-free interval (PFI) was 4 months. The ORR and DCR were 51.9% and 92.6%, respectively. Median PFS and OS were 7.9 months and 16.1 months, respectively. PFS and OS of patients with 3-6 months PFI were significantly longer than those with PFI < 3 months (median PFS, 9.7 vs. 5.8 months; p < 0.01; median OS, 20.0 vs. 12.1 months; p = 0.03). Grade 3 or 4 hematological toxicities observed included neutropenia (71.0%), leukopenia (54.8%), anemia (51.6%), and thrombocytopenia (25.8%). No other grade 2-4 nonhematological toxicity was observed except for hypertension in one and CBDCA hypersensitivity reaction in two.

Conclusion: GC ± B may be effective and safe treatment alternative for PROC, especially with PFI of 3-6 months, despite hematological toxicity.

Keywords: Bevacizumab; Carboplatin; Gemcitabine; Platinum rechallenge; Platinum-resistant ovarian cancer.

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