Bevacizumab has demonstrated significant benefit in recurrent ovarian, fallopian tube and peritoneal cancer (OC), but its optimal position within the sequence of systemic therapies remains controversial. Since rebound progression after bevacizumab has been observed in other cancers, and because bevacizumab is incorporated in several regimens used in the recurrent setting, the duration of treatment may impact survival. We sought to identify whether earlier bevacizumab exposure is associated with prolonged bevacizumab therapy and survival by conducting a multi-institution retrospective study of recurrent OC patients treated with bevacizumab from 2004–2014. Multivariate logistic regression identified factors associated with receiving more than six bevacizumab cycles. Overall survival by duration and ordinal sequence of bevacizumab therapy were evaluated using logrank testing and Cox regression. In total, 318 patients were identified. 89.1% had stage III or IV disease; 36% had primary platinum resistance; 40.5% received two or fewer prior chemotherapy regimens. Multivariate logistic regression demonstrated that primary platinum sensitivity (Odds Ratio (OR) 2.34, p = 0.001) or initiating bevacizumab at the first or second recurrence (OR 2.73, p < 0.001) were independently associated with receiving more than six cycles of bevacizumab. Receiving more cycles of bevacizumab was associated with improved overall survival whether measured from time of diagnosis (logrank p < 0.001), bevacizumab initiation (logrank p < 0.001), or bevacizumab discontinuation (logrank p = 0.017). Waiting one additional recurrence to initiate bevacizumab resulted in a 27% increased hazard of death (Hazard Ratio (HR) 1.27, p < 0.001) by multivariate analysis. In conclusion, patients with primary platinum sensitive disease who received fewer prior lines of chemotherapy were able to receive more cycles of bevacizumab, which was associated with improved overall survival. Survival worsened when bevacizumab was initiated later in the ordinal sequence of therapies.
Lee Breuer's The Gospel at Colonus foregrounds the themes found in Oedipus at Colonus, of reconciliation and integration, and tests them against America's racially divided society. The analyses in this chapter concentrate on various comparisons between Gospel and its Greek antecedent: on the representation of Oedipus, on descriptions of time and change, on the inconcinnity between the Christian and the Greek worldviews, and on the notion of place. The chapter shows that Gospel reworks the exacting bleakness of the Greek play in the service of a vision of a racially integrated American polity. Its utopian politics, however, may be compromised by its other allegiances, including its commitment to the theatrical roots of tragedy. To pursue this tension, the play is read in relation to the traditions of gospel music, other black theatre, and the American avant-garde.
Femi Osofisan's Tegonni: an African Antigone moves beyond a concern with the political and cultural effects of colonialism. Instead, the play deconstructs colonial and other types of authority, including paternal power and the domination of the male, in the service of resistance to neo-colonialism. In place of traditional authorities it foregrounds relationships of spontaneous affection, female agency, and a comic dimension. The self-conscious metatheatricality of the drama serves the same project; Tegonni doubles its heroine between a mythical Greek Antigone and a nineteenth-century Yoruba princess, and thus can address, like Odale's Choice, the issue of a sacrifice that is efficacious but must be repeated. The authority of the Greek Antigone comes to symbolize the tragic inevitability of Africa's damaged history, but is countered both by the comedy in the play, represented most forcefully by the soldiers, and by the tradition of Antigones set in Africa.
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