Bevacizumab therapy in advanced ovarian cancer

Abstract

Ovarian cancer is the leading cause of death among all gynaecological cancers, the estimated number of new ovarian cancer cases in Europe in 2012 was 65.538 with 42.704 deaths, and the most common and most lethal sub-type is high-grade serous carcinoma.

Bevacizumab (15 mg/kg q3w) is approved in combination with platinum regimens. The OCEANS trial shows a PFS (Progression-free survival) improvement for carboplatin/gemcitabine regimen, and the GOG 123 trial also shows a similar improvement for paclitaxel/carboplatin regimen. The AURELIA trial seems to confirm the possibility to improve the clinical outcome in ovarian cancer, justifying treatment with a prolonged use of bevacizumab, mostly in patients requiring a palliation therapy without toxicity. AURELIA must to be considered the first study, investigating the role of bevacizumab treatment in ovarian cancer, to demonstrate a statistically significant improvement in PROs.

Treatment prolongation with bevacizumab seems to be feasible, but final conclusion could be drawn only when the final results of AGO-OVAR17, a phase III randomized trial comparing 15 vs 30 months of bevacizumab therapy, will be available.

Keywords: ovarian cancer, bevacizumab, side effects, anti-angiogenesis, trial

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