title: Bevacizumab plus microtubule targeting agents in heavily pre-treated ovarian cancer patients: a retrospective study.
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.
authors.affiliation: CHU Hautepierre, Department of Oncology & Hematology, Strasbourg, France. irene.asmane@wanadoo.fr
authors.forename: Irène
authors.initials: I
authors.lastname: Asmane
authors.forename: Jean-Emmanuel
authors.initials: JE
authors.lastname: Kurtz
authors.forename: Agathe
authors.initials: A
authors.lastname: Bajard
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Guastalla
authors.forename: Pierre
authors.initials: P
authors.lastname: Meeus
authors.forename: Olivier
authors.initials: O
authors.lastname: Tredan
authors.forename: Intidhar
authors.initials: I
authors.lastname: Labidi Galy
authors.forename: Isabelle
authors.initials: I
authors.lastname: Moullet
authors.forename: Philippe
authors.initials: P
authors.lastname: Ardisson
authors.forename: Lionel
authors.initials: L
authors.lastname: Vincent
authors.forename: David
authors.initials: D
authors.lastname: Coeffic
authors.forename: Armelle
authors.initials: A
authors.lastname: Dufresne
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Bergerat
authors.forename: Isabelle
authors.initials: I
authors.lastname: Ray-Coquard
mesh_terms: D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D000068258:Bevacizumab; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D000077216:Carcinoma, Ovarian Epithelial; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D000077143:Docetaxel; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000139:chemically induced; D007416:Intestinal Perforation / Q000139:chemically induced; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000098:blood supply / Q000188:drug therapy* / Q000401:mortality; D010051:Ovarian Neoplasms / Q000098:blood supply / Q000188:drug therapy* / Q000401:mortality; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D012006:Rectovaginal Fistula / Q000139:chemically induced; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome; D001747:Urinary Bladder Fistula / Q000139:chemically induced; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014747:Vinblastine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D000077235:Vinorelbine
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D043823:Taxoids; D042461:Vascular Endothelial Growth Factor A; D000077143:Docetaxel; D000068258:Bevacizumab; D014747:Vinblastine; D003520:Cyclophosphamide; D016190:Carboplatin; D017239:Paclitaxel; D000077235:Vinorelbine