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Bevacizumab combination therapy in recurrent, platinum-refractory, epithelial ovarian carcinoma: A retrospective analysis.

AbstractBACKGROUND:
The study was undertaken to determine the safety and efficacy of the monoclonal, antivascular endothelial growth factor antibody bevacizumab in combination with cytotoxic chemotherapy for women with platinum-refractory ovarian cancer.
METHODS:
A retrospective analysis of women who received bevacizumab in combination with a cytotoxic agent was performed. Response was determined by measurable disease or assessment of serial cancer antigen (CA) 125 measurements.
RESULTS:
Twenty-three patients were identified. The patients were heavily pretreated with a median of 7 prior regimens including a median of 3 prior platinum regimens. The combination regimen included cyclophosphamide in 15 (65%), 5-fluorouracil (5-FU) in 6 (26%), docetaxel in 1 (4%), and gemcitibine/liposomal doxorubicin in 1 (4%). Two (9%) women developed chylous ascites during treatment. CTC Grade 4-5 toxicities occurred in 4 (17%) subjects. Gastrointestinal perforation occurred in 2 (9%) patients. Measurable disease was present in 22. The overall best response rate was 35% and all 8 were partial responses (PRs). Stable disease was found in a further 10 (44%) women, whereas progressive disease was observed in 5 (22%). The median time to progression was 5.6 months in patients with a PR and 2.3 months in subjects with stable disease. Three (13%) women experienced a progression-free interval (PFI) of >6 months. At last follow-up, 8 (35%) subjects had died of disease, whereas 15 (65%) women were alive with disease.
CONCLUSIONS:
Combination bevacizumab therapy demonstrated activity in heavily pretreated women with ovarian cancer. Gastrointestinal perforations were identified in 9%. Despite the toxicity of the regimen, prospective studies, particularly in less heavily pretreated patients, are warranted.
AuthorsJason D Wright, Andrea Hagemann, Janet S Rader, Dana Viviano, Randall K Gibb, Lori Norris, David G Mutch, Matthew A Powell
JournalCancer (Cancer) Vol. 107 Issue 1 Pg. 83-9 (Jul 01 2006) ISSN: 0008-543X [Print] United States
PMID16736514 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
CopyrightCopyright 2006 American Cancer Society.
Chemical References
  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Platinum Compounds
  • Taxoids
  • Deoxycytidine
  • Docetaxel
  • Bevacizumab
  • Doxorubicin
  • Cyclophosphamide
  • Fluorouracil
  • Gemcitabine
Topics
  • Adult
  • Aged
  • Angiogenesis Inhibitors (adverse effects, therapeutic use)
  • Antibodies, Monoclonal (adverse effects, therapeutic use)
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
  • Bevacizumab
  • Cohort Studies
  • Cyclophosphamide (administration & dosage)
  • Deoxycytidine (administration & dosage, analogs & derivatives)
  • Docetaxel
  • Doxorubicin (administration & dosage)
  • Drug Resistance, Neoplasm
  • Female
  • Fluorouracil (administration & dosage)
  • Humans
  • Intestinal Perforation (chemically induced)
  • Middle Aged
  • Neoplasms, Glandular and Epithelial (drug therapy)
  • Ovarian Neoplasms (drug therapy)
  • Platinum Compounds (administration & dosage)
  • Retrospective Studies
  • Taxoids (administration & dosage)
  • Tomography Scanners, X-Ray Computed
  • Treatment Outcome
  • Gemcitabine

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