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

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.

Duke Scholars

Author Angeles Alvarez Secord Obstetrics and Gynecology, Gynecologic Oncology