Safety and Efficacy of Extended Bevacizumab Therapy in Elderly (≥70 Years) Versus Younger Patients Treated for Newly Diagnosed Ovarian Cancer in the International ROSiA Study

Selle, Frédèric; Colombo, Nicoletta; Korach, Jacob; Mendiola, C.; Cardona, Andrés F.; Ghazi, Y.; Oza, Amit M.

doi:10.1097/igc.0000000000001221

Cited by 23 publications

(26 citation statements)

References 26 publications

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“…This finding is consistent with published safety results from the GEICO 1205 and ANTHALYA randomized phase II trials evaluating neoadjuvant bevacizumab; neither identified any particular safety concerns with neoadjuvant administration of bevacizumab 10 11. Hypertension and thromboembolic events were slightly more common in older than younger patients; this finding is consistent with the known increased risk of these events in older patients and those with pre-existing hypertension, irrespective of treatment, and is also consistent with findings from the ROSiA study 12…”

Section: Discussionsupporting

confidence: 89%

Role of front-line bevacizumab in advanced ovarian cancer: the OSCAR study

Hall

Bertelli

et al. 2019

Int J Gynecol Cancer

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ObjectiveTwo randomized phase III trials demonstrated the efficacy and safety of combining bevacizumab with front-line carboplatin/paclitaxel for advanced ovarian cancer. The OSCAR (NCT01863693) study assessed the impact of front-line bevacizumab-containing therapy on safety and oncologic outcomes in patients with advanced ovarian cancer in the UK.MethodsBetween May 2013 and April 2015, patients with high-risk stage IIIB–IV advanced ovarian cancer received bevacizumab (7.5 or 15 mg/kg every 3 weeks, typically for ≤12 months, per UK clinical practice) combined with front-line chemotherapy, with bevacizumab continued as maintenance therapy. Co-primary endpoints were progression-free survival and safety (NCI-CTCAE v4.0). Patients were evaluated per standard practice/physician’s discretion.ResultsA total of 299 patients received bevacizumab-containing therapy. The median age was 64 years (range 31–83); 80 patients (27%) were aged ≥70 years. Surgical interventions were primary debulking in 21%, interval debulking in 36%, and none in 43%. Most patients (93%) received bevacizumab 7.5 mg/kg with carboplatin/paclitaxel. Median duration of bevacizumab was 10.5 months(range <0.1–41.4); bevacizumab and chemotherapy were given in combination for a median of three cycles (range 1–10). Median progression-free survival was 15.4 (95% CI 14.5 to 16.9) months. Subgroup analyses according to prior surgery showed median progression-free survival of 20.8, 16.1, and 13.6 months in patients with primary debulking, interval debulking, and no surgery, respectively. Median progression-free survival was 16.1 vs 14.8 months in patients aged <70 versus ≥70 years, respectively. The 1-year overall survival rate was 94%. Grade 3/4 adverse events occurred in 54% of patients, the most common being hypertension (16%) and neutropenia (5%). Thirty-five patients (12%) discontinued bevacizumab for toxicity (most often for proteinuria (2%)).ConclusionsMedian progression-free survival in this study was similar to that in the high-risk subgroup of the ICON7 phase III trial. Median progression-free survival was shortest in patients who did not undergo surgery.

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Section: Discussionsupporting

confidence: 89%

Role of front-line bevacizumab in advanced ovarian cancer: the OSCAR study

Hall

Bertelli

et al. 2019

Int J Gynecol Cancer

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“…Additionally, the two age groups did not significantly differ in PFS or OS. Several previous reports have suggested that the efficacy of bevacizumab-containing therapy is similar in older and younger patients with ovarian cancer (15)(16)(17). Although these reports investigated treatment with bevacizumab in combination with other cytotoxic agents, the results are consistent with our study, which evaluated bevacizumab monotherapy.…”

Section: Discussionsupporting

confidence: 91%

“…To date, the tolerability of bevacizumab therapy in older ovarian cancer patients has only been investigated in a limited number of studies. Selle et al have evaluated bevacizumab-containing therapy tolerability when used as a first-line treatment in older patients with ovarian cancer (17). The findings of their study indicated that there were higher incidences of all grade anemia, diarrhea, and grade ≥3 hypertension, and thromboembolic events in ovarian cancer patients aged ≥70 years as compared to those <70 years.…”

Section: Discussionmentioning

confidence: 99%

Tolerability and Efficacy of Bevacizumab Monotherapy in Older Patients With Recurrent Ovarian Cancer

Shintani

Yoshida

Yabuno

2020

In Vivo

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Background/Aim: The aim of this study was to compare the tolerability and efficacy of bevacizumab monotherapy between older and younger patients with recurrent ovarian cancer. Patients and Methods: We enrolled 32 patients with recurrent ovarian cancer who were treated with bevacizumab monotherapy and divided them into those who were 65 years and older (n=12) and those younger than 65 years (n=20). Results: Except for grade ≥3 proteinuria, incidences of adverse events did not differ significantly between the groups. Although older patients exhibited more frequently cycle delay caused by non-hematological toxicities, this difference was not significant. There was no significant difference in tumor response and survival between the groups. Conclusion: Bevacizumab monotherapy was tolerable and effective for older patients with recurrent ovarian cancer compared with younger patients.

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“…Median PFS was similar (23.7 versus 25.6 months) to that in younger patients despite the worse prognosis. Older age should not preclude bevacizumab therapy for ovarian cancer, but elderly patients should be monitored more closely while receiving bevacizumab (26). There are many others ongoing clinical trials that investigate the role of bevacizumab in combination with other targeted drugs in first line therapy setting.…”

Section: Discussionmentioning

confidence: 99%

First-line treatment of ovarian cancer FIGO stages IIIB-IV: focus on therapy with bevacizumab - our experience

et al. 2020

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Epithelial ovarian cancer is the seventh most common cancer among women and the leading cause of gynecological cancer related deaths in Croatia. Approximately 70% of patients are diagnosed at an advanced stage of the disease (FIGO III and IV). The usual approach to treatment involves complete surgical cytoreduction (R0), followed by combined platinumbased chemotherapy. Bevacizumab is recommended to add to paclitaxel/carboplatin chemotherapy in patients diagnosed at FIGO IIIB and IIIC stage with residual disease after surgery and all patients FIGO IV stage of disease, which can extend the time to progression of the disease in these patients. In this retrospective study, we analyzed the medical data of 98 patients with newly diagnosed advanced FIGO IIIB-IV epithelial ovarian, fallopian tube, or primary peritoneal cancer treated at the Department of Gynecology and Obstetrics in the University Hospital Centre Zagreb in the period from January 2017 to December 2018. We have analyzed the following data: age, ECOG status, FIGO stage of disease, principle of surgery, pathohistological type of the tumor, number and type of adjuvant chemotherapy, application of bevacizumab, number of bevacizumab cycles, side effects related to bevacizumab therapy. Data from 98 patients were obtained. The median age was 60 years. The most patients were ECOG status 0-1 (78 %). According to the pathohistological findings, 89 % of patients had serous carcinoma, 5% endometrioid carcinoma, 3% mucinous carcinoma, 1% clear cell carcinoma, 1% borderline tumors and 1% poorly differentiated epithelial carcinoma. Most of the patients (68.5%) were underwent to primary cytoreduction, 12% "interval debulking" operation, whereas biopsy was performed in only 19.5% patients. HIPEC during surgery had 6% of patients. Resection without residual disease was achieved in only 25.5% of patients underwent surgery, while in others were reported macroscopic residual disease after surgery. 87% of patients were treated with chemotherapy with paclitaxel and carboplatin in three weeks schedule. 38 patients received antiangiogenetic drug bevacizumab. After exclusion of patients with a poor general condition (ECOG 2-4) and patients with FIGO stage IIIB and IIIC without residual disease after surgery, the percentage of patients receiving bevacizumab was 56% in 2017 and 75% in 2018. The average number of received cycles was 13 (range 1-22), and 8 patients continued the therapy in May 2019. Sixty-eight percent of the patients which received bevacizumab did not have any side effects associated with the bevacizumab therapy. The most common side effects associated with the bevacizumab were hypertension, development of deep vein thrombosis, ileus and proteinuria. In Croatia, since February 2017, we have the possibility of using bevacizumab for the treatment of newly diagnosed ovarian cancer patients stage IV or incompletely resected patients stages III B and III C. Our results are in concordance with the literature data and show that we can safely add bevacizumab to the first lin...

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Safety and Efficacy of Extended Bevacizumab Therapy in Elderly (≥70 Years) Versus Younger Patients Treated for Newly Diagnosed Ovarian Cancer in the International ROSiA Study

Cited by 23 publications

References 26 publications

Role of front-line bevacizumab in advanced ovarian cancer: the OSCAR study

Role of front-line bevacizumab in advanced ovarian cancer: the OSCAR study

Tolerability and Efficacy of Bevacizumab Monotherapy in Older Patients With Recurrent Ovarian Cancer

First-line treatment of ovarian cancer FIGO stages IIIB-IV: focus on therapy with bevacizumab - our experience

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