title: Recurrent ovarian cancer: is there a role for re-treatment with bevacizumab after an initial complete response to a bevacizumab-containing regimen?
abstract: OBJECTIVE
  To compare the progression free survival (PFS) and overall survival (OS) in patients with epithelial ovarian cancer (EOC) who received Bev after Bev (BAB) vs. those who were not re-treated with Bev (NOTBev) after initially experiencing a complete response (CR) to a Bev-containing regimen (BCR).
  
  
  METHODS
  We performed a retrospective chart review of patients with EOC that received Bev in either the front-line or recurrent setting. Patients who received additional therapy after achieving a CR to BCR were analyzed.
  
  
  RESULTS
  36 patients who had a CR to a BCR were included, 17 who received Bev at the time of their subsequent recurrence vs. 19 that did not. More patients in the NOTBev group received Bev as primary therapy (21% vs. 6%, p=0.2), but this was not statistically significant. Patients in the BAB group had significantly higher mean PFS compared to the NOTBev group (20 vs. 6 months, p=0.0019). On adjusting for covariates, there was a 78% improvement in their PFS (HR 0.22, p=0.0048). No difference in overall survival was noted between the groups (23 vs. 26 months, p=0.7244).
  
  
  CONCLUSIONS
  Re-treatment with Bev after a prior Bev response is associated with a significantly improved PFS. This is the first of such reports in this patient population. The 14-month improvement in PFS strongly supports the re-use of Bev in patients who demonstrate an initial response to Bev. This strategy should be formally tested in future clinical trials and further investigation should include evaluation of predictors of response to Bev therapy.
authors.affiliation: David.O'Malley@osumc.edu
authors.forename: Georgia A
authors.initials: GA
authors.lastname: McCann
authors.forename: Blair
authors.initials: B
authors.lastname: Smith
authors.forename: Floor J
authors.initials: FJ
authors.lastname: Backes
authors.forename: Kellie
authors.initials: K
authors.lastname: Rath
authors.forename: Simi
authors.initials: S
authors.lastname: Chacko
authors.forename: Ritu
authors.initials: R
authors.lastname: Salani
authors.forename: Eric
authors.initials: E
authors.lastname: Eisenhauer
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Fowler
authors.forename: David E
authors.initials: DE
authors.lastname: Cohn
authors.forename: David M
authors.initials: DM
authors.lastname: O'Malley
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage* / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000068258:Bevacizumab; D000077216:Carcinoma, Ovarian Epithelial; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab