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Comparative Study
. 2025 Mar:194:112-118.
doi: 10.1016/j.ygyno.2025.02.015. Epub 2025 Feb 22.

Bevacizumab beyond progression: Impact of subsequent bevacizumab re-treatment in patients with ovarian, fallopian tube, and peritoneal cancer after progression

Amma Asare  1 , Rebecca Ann Previs  2 , Daniel Spinosa  3 , Bryan Fellman  1 , Amelia L Scott  4 , Isabelle Mulder  1 , May Mahmoud  1 , Ahmed Enbaya  1 , Jean Hansen Siedel  1 , Lauren Cobb  1 , Pamela T Soliman  1 , Anil K Sood  1 , Robert L Coleman  5 , Angeles Alvarez Secord  3 , Shannon N Westin  6
Affiliations
Comparative Study

Bevacizumab beyond progression: Impact of subsequent bevacizumab re-treatment in patients with ovarian, fallopian tube, and peritoneal cancer after progression

Amma Asare et al. Gynecol Oncol. 2025 Mar.

Abstract

Background: This study evaluated whether patients with epithelial ovarian, fallopian tube, and primary peritoneal carcinoma (OC) who are immediately re-treated with bevacizumab derive benefit after disease progression on a bevacizumab-containing regimen.

Methods: This multi-institutional, retrospective study compared patients with high grade non-mucinous epithelial OC who received bevacizumab followed directly by another bevacizumab-containing treatment regimen to patients who received bevacizumab followed by a regimen that did not contain bevacizumab (or received no further treatment). Progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan Meier product-limit estimator and modeled via Cox proportional hazards regression.

Results: Among 226 patients with OC who received bevacizumab as part of a treatment regimen,103 received sequential treatment with bevacizumab and 123 received a bevacizumab-containing regimen followed by a non-bevacizumab-containing regimen at the time of progression. Median follow-up for all subjects was 17.3 months (range, 1.2-138.2 months). Median PFS was 17.2 months (95 % CI, 14.3-21.2) for patients who received sequential bevacizumab re-treatment and 5.1 months (95 % CI, 4.3-6.3) for patients who received bevacizumab without bevacizumab-containing re-treatment (p < 0.001). Median OS was 29.9 months (95 % CI, 26.1-35.4) for patients who received sequential bevacizumab re-treatment (p < 0.001) and 12.4 months (95 % CI, 9.2-16.7) for patients who did not receive bevacizumab-containing re-treatment.

Conclusion: Patients with OC treated with bevacizumab-containing regimens sequentially at the time of progression have prolonged survival compared to patients who received no re-treatment with bevacizumab.

Keywords: Angiogenesis inhibitors; Bevacizumab; Fallopian tube cancer; Ovarian cancer.

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Conflict of interest statement

Declaration of competing interest RP has received consulting fees from Myriad Genetics and Natera. RP is employed by Labcorp. SNW has received research support to her institution from AstraZeneca, AvengeBio, Bayer, Bio-Path, Clovis Oncology/Pharm&, GSK, Jazz Pharmaceuticals, Mereo, Novartis, Nuvectis, Roche/Genentech, Zentalis and consulting fees from AstraZeneca, Caris, Clovis Oncology/Pharma&, Eisai, EQRX, Gilead, GSK, Immunocore, ImmunoGen, Lilly, Loxo, Merck, Mereo, Mersana, NGM Bio, Roche/Genentech, Seagen, Verastem, Vincerx, Zentalis, and ZielBio. AKS: shareholder of BioPath and a consultant for Merck, AstraZeneca, Onxeo, ImmunoGen, Ivlon, GSK, and Kiyatec. The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions. The Institutional Review Boards and relevant regulatory bodies at The University of Texas MD Anderson Cancer Center and Duke University Medical Center approved this study. Editorial support was provided by Bryan Tutt, Scientific Editor, Research Medical Library MD Anderson Cancer Center.

Figures

Figure 1.
Figure 1.
Flow diagram of study methods.
Figure 2.
Figure 2.
(A) Median progression-free survival was 17.2 months (95% CI: 14.3–21.2) versus 5.1 months (95% CI: 4.3–6.3) (p < 0.001) for patients with ovarian cancer who received bevacizumab followed by sequential re-treatment with bevacizumab versus no bevacizumab-containing re-treatment. (B) Median overall survival was 29.9 months (95% CI: 26.1–35.4) for patients who received sequential bevacizumab re-treatment (p < 0.001) and 12.4 months (95% CI: 9.2–16.7) for patients who did not receive bevacizumab-containing re-treatment. Abbreviations: Bev, bevacizumab
Figure 3.
Figure 3.
(A) Progression-free survival of patients with ovarian cancer who received bevacizumab followed by re-treatment with bevacizumab or no bevacizumab-containing re-treatment whose best overall response (BOR) to bevacizumab during their first treatment was a complete response, partial response, or stable disease. (B) Progression-free survival of patients with ovarian cancer who received bevacizumab followed by re-treatment with bevacizumab or no bevacizumab-containing re-treatment whose BOR was progressive disease after their first treatment with bevacizumab. (C) Overall survival of patients with ovarian cancer who received bevacizumab followed by re-treatment with bevacizumab or no bevacizumab-containing re-treatment whose BOR to bevacizumab during their first treatment was a complete response, partial response, or stable disease. (D) Overall survival of patients with ovarian cancer who received bevacizumab followed by re-treatment with bevacizumab or no bevacizumab-containing re-treatment whose BOR was progressive disease after their first treatment with bevacizumab. Abbreviations: BOR, best overall response; Bev, bevacizumab, CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease.
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