title: Bevacizumab and ovarian cancer.
abstract: OBJECTIVE
  Vascular endothelial growth factor (VEGF), one of the major pathways involved in tumor angiogenesis, is often overexpressed in epithelial ovarian cancer (EOC), and therefore an attractive target for therapy. This review aims to evaluate the rationale for targeting angiogenic pathways by the usage of the anti-VEGF agent bevacizumab in EOC.
  
  
  RESULTS
  Bevacizumab monotherapy has been shown to be effective in the treatment of EOC with response rate of 16-21% in phase II trials. In phase III trials, patients with advanced EOC who received combination chemotherapy (paclitaxel + carboplatin) plus bevacizumab with maintenance bevacizumab had significantly longer progression-free survival than those who received chemotherapy alone, but did not prolong overall survival. The most common grade 3/4 adverse events of bevacizumab monotherapy include hypertension and proteinuria, while heavily pretreated patients were at increased risk of bowel perforation. The addition of bevacizumab to the standard chemotherapy in patients with advanced EOC may not be cost-effective.
  
  
  CONCLUSIONS
  Bevacizumab has significant activity and is the most promising drug in EOC. However, understanding of its unique adverse events and identification of predictive biomarkers of bevacizumab response are necessary in order to select patients most likely to benefit from this therapy.
authors: Department of Obstetrics and Gynecology, Tottori University School of Medicine, Yonago, Tottori, Japan.
authors: Shinya
authors: S
authors: Sato
authors: Hiroaki
authors: H
authors: Itamochi
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab; D016190:Carboplatin / Q000008:administration & dosage; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D003362:Cost-Benefit Analysis; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D007416:Intestinal Perforation / Q000139:chemically induced; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D017239:Paclitaxel / Q000008:administration & dosage; D011507:Proteinuria / Q000139:chemically induced; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D016190:Carboplatin; D017239:Paclitaxel