Bevacizumab Plus Microtubule Targeting Agents in Heavily Pre-Treated Ovarian Cancer Patients: A Retrospective Study

Bull Cancer. 2011 Oct;98(9):80-9. doi: 10.1684/bdc.2011.1436.

Abstract

OBJECTIVES. As vascular endothelial growth factor (VEGF) is expressed in ovarian cancer, we assessed the efficacy and safety of bevacizumab (a monoclonal antibody targeting VEGF) plus microtubule targeting agents for heavily pre-treated ovarian carcinoma patients. METHODS. We retrospectively reviewed 43 patients with recurrent epithelial ovarian carcinoma. Combined treatment included bevacizumab with paclitaxel in 32 (74%), docetaxel in 10 (23%), and vinorelbine in one (2.3%) patients, respectively. RESULTS. The median number of combined treatment was six cycles (range 1-29). On RECIST criteria, the objective response rate (ORR) was 40% (16% CR and 24% PR). Clinical benefit (complete response [CR] plus partial response [PR] and stable disease [SD] lasting ≥ 3 months) was 74% (CI95%: 46.7-77%). Median duration of treatment and overall survival were 3.9 months (range 0.2-14.4 months) and 20.1 months (CI95%: 13.8-20.1) respectively. No toxic death was reported. Grade 3-4 toxicity occurred in 30% of patients. Gastrointestinal perforations and fistula occurred in 3 (7%) and 6 (14%) patients, respectively. CONCLUSION. Although being active in terms of ORR, bevacizumab plus microtubule targeting agents - mainly taxanes - leads to a high rate of gastro-intestinal perforations and fistula in heavily pre-treated ovarian carcinoma patients.

MeSH terms

  • Adult
  • Aged
  • Angiogenesis Inhibitors / adverse effects
  • Angiogenesis Inhibitors / therapeutic use*
  • Antibodies, Monoclonal / adverse effects
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bevacizumab
  • Carboplatin / administration & dosage
  • Carboplatin / adverse effects
  • Carcinoma, Ovarian Epithelial
  • Cyclophosphamide / administration & dosage
  • Cyclophosphamide / adverse effects
  • Docetaxel
  • Drug Administration Schedule
  • Female
  • Humans
  • Intestinal Fistula / chemically induced
  • Intestinal Perforation / chemically induced
  • Middle Aged
  • Neoplasms, Glandular and Epithelial / blood supply
  • Neoplasms, Glandular and Epithelial / drug therapy*
  • Neoplasms, Glandular and Epithelial / mortality
  • Ovarian Neoplasms / blood supply
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / mortality
  • Paclitaxel / administration & dosage
  • Paclitaxel / adverse effects
  • Rectovaginal Fistula / chemically induced
  • Retrospective Studies
  • Taxoids / administration & dosage
  • Taxoids / adverse effects
  • Treatment Outcome
  • Urinary Bladder Fistula / chemically induced
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors*
  • Vinblastine / administration & dosage
  • Vinblastine / adverse effects
  • Vinblastine / analogs & derivatives
  • Vinorelbine

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Taxoids
  • Vascular Endothelial Growth Factor A
  • Docetaxel
  • Bevacizumab
  • Vinblastine
  • Cyclophosphamide
  • Carboplatin
  • Paclitaxel
  • Vinorelbine