Bevacizumab is a recombinant, humanized anti-
vascular endothelial growth factor (
VEGF)
monoclonal antibody that neutralizes the
biological activity of
VEGF and inhibits tumour angiogenesis. In two pivotal, well designed, phase III, clinical trials (GOG-0218 and ICON7) in women with advanced epithelial ovarian, fallopian tube or primary peritoneal
cancer, first-line treatment with
bevacizumab in combination with standard
chemotherapy (
carboplatin plus
paclitaxel) followed by maintenance treatment with
bevacizumab alone significantly prolonged progression-free survival relative to standard
chemotherapy. A subgroup analysis of ICON7 suggested that
bevacizumab therapy may also be beneficial in patients at high risk of
disease progression. In GOG-0218, health-related quality of life (HR-QOL) deteriorated temporarily (during the
chemotherapy phase) and slightly, although statistically significantly, with
bevacizumab in combination with standard
chemotherapy followed by
bevacizumab maintenance relative to standard
chemotherapy plus placebo maintenance. In ICON7, HR-QOL did not differ to a clinically significant extent between patients receiving
bevacizumab plus standard
chemotherapy followed by
bevacizumab maintenance and those receiving standard
chemotherapy alone.
Bevacizumab combination
therapy had generally acceptable tolerability in these studies, with the nature of adverse events generally similar to that observed in previous clinical trials in patients with other solid tumours.