Addition of bevacizumab to weekly paclitaxel significantly improves progression-free survival in heavily pretreated recurrent epithelial ovarian cancer

David M. O'Malley, Debra L. Richardson, Patrick S. Rheaume, Ritu Salani, Eric L. Eisenhauer, Georgia A. McCann, Jeffrey M. Fowler, Larry J. Copeland, David E. Cohn, Floor J. Backes

Research output: Contribution to journalArticle

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Abstract

Objective: Weekly paclitaxel has been shown to be an effective cytotoxic regimen for recurrent epithelial ovarian cancer (EOC), and may act through inhibition of angiogenesis. Bevacizumab, a potent angiogenesis inhibitor, has also been shown to have activity in patients with EOC. Therefore, we sought to determine if the addition of bevacizumab to weekly paclitaxel led to an increased survival compared to weekly paclitaxel alone. Methods: A single institutional review was conducted for patients with recurrent EOC treated with weekly paclitaxel (60-70 mg/m2) on days 1, 8, 15, and 22 of a 28 day cycle and those treated with weekly paclitaxel and bevacizumab (10-15 mg/kg on day 1 and 15). Response rates (RR) were calculated, and progression-free survival (PFS), and overall survival (OS) were compared using Kaplan-Meier survival analysis. Results: Twenty-nine patients treated with weekly paclitaxel and 41 patients treated with paclitaxel/bevacizumab were identified. The groups were similar in demographics, initial optimal cytoreduction, stage, histology, grade, platinum sensitivity, and median number of previous regimens (4 vs. 4, p = 0.69).The overall response rate (ORR) was 63% (complete response (CR) 34% and partial response (PR) 29%) for paclitaxel/bevacizumab and 48% (CR 17% and PR 31%) for weekly paclitaxel (p = 0.23). Improvement in PFS was seen in those treated with paclitaxel/bevacizumab in comparison to weekly paclitaxel alone (median PFS 13.2 vs. 6.2 months, p < .01). There was a trend towards improved OS for paclitaxel/bevacizumab (median OS 20.6 vs. 9.1 months; p = 0.12). Toxicities were similar between the two regimens although more bowel perforations (2 vs. 0) were seen in the paclitaxel/bevacizumab group. Conclusion: A significant increase in PFS with a trend towards improved OS was demonstrated in this heavily pretreated population treated with paclitaxel/bevacizumab as compared to weekly paclitaxel alone. This data should be helpful in guiding future trials to determine the optimal care for women with recurrent EOC.

Original languageEnglish (US)
Pages (from-to)269-272
Number of pages4
JournalGynecologic Oncology
Volume121
Issue number2
DOIs
StatePublished - May 1 2011

Fingerprint

Paclitaxel
Disease-Free Survival
Survival
Bevacizumab
Ovarian epithelial cancer
Angiogenesis Inhibitors
Kaplan-Meier Estimate
Survival Analysis
Platinum
Histology

Keywords

  • Bevacizumab
  • Chemotherapy
  • Recurrent ovarian cancer
  • Treatment
  • Weekly paclitaxel

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Addition of bevacizumab to weekly paclitaxel significantly improves progression-free survival in heavily pretreated recurrent epithelial ovarian cancer. / O'Malley, David M.; Richardson, Debra L.; Rheaume, Patrick S.; Salani, Ritu; Eisenhauer, Eric L.; McCann, Georgia A.; Fowler, Jeffrey M.; Copeland, Larry J.; Cohn, David E.; Backes, Floor J.

In: Gynecologic Oncology, Vol. 121, No. 2, 01.05.2011, p. 269-272.

Research output: Contribution to journalArticle

O'Malley, DM, Richardson, DL, Rheaume, PS, Salani, R, Eisenhauer, EL, McCann, GA, Fowler, JM, Copeland, LJ, Cohn, DE & Backes, FJ 2011, 'Addition of bevacizumab to weekly paclitaxel significantly improves progression-free survival in heavily pretreated recurrent epithelial ovarian cancer', Gynecologic Oncology, vol. 121, no. 2, pp. 269-272. https://doi.org/10.1016/j.ygyno.2011.01.009
O'Malley, David M. ; Richardson, Debra L. ; Rheaume, Patrick S. ; Salani, Ritu ; Eisenhauer, Eric L. ; McCann, Georgia A. ; Fowler, Jeffrey M. ; Copeland, Larry J. ; Cohn, David E. ; Backes, Floor J. / Addition of bevacizumab to weekly paclitaxel significantly improves progression-free survival in heavily pretreated recurrent epithelial ovarian cancer. In: Gynecologic Oncology. 2011 ; Vol. 121, No. 2. pp. 269-272.
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T1 - Addition of bevacizumab to weekly paclitaxel significantly improves progression-free survival in heavily pretreated recurrent epithelial ovarian cancer

AU - O'Malley, David M.

AU - Richardson, Debra L.

AU - Rheaume, Patrick S.

AU - Salani, Ritu

AU - Eisenhauer, Eric L.

AU - McCann, Georgia A.

AU - Fowler, Jeffrey M.

AU - Copeland, Larry J.

AU - Cohn, David E.

AU - Backes, Floor J.

PY - 2011/5/1

Y1 - 2011/5/1

N2 - Objective: Weekly paclitaxel has been shown to be an effective cytotoxic regimen for recurrent epithelial ovarian cancer (EOC), and may act through inhibition of angiogenesis. Bevacizumab, a potent angiogenesis inhibitor, has also been shown to have activity in patients with EOC. Therefore, we sought to determine if the addition of bevacizumab to weekly paclitaxel led to an increased survival compared to weekly paclitaxel alone. Methods: A single institutional review was conducted for patients with recurrent EOC treated with weekly paclitaxel (60-70 mg/m2) on days 1, 8, 15, and 22 of a 28 day cycle and those treated with weekly paclitaxel and bevacizumab (10-15 mg/kg on day 1 and 15). Response rates (RR) were calculated, and progression-free survival (PFS), and overall survival (OS) were compared using Kaplan-Meier survival analysis. Results: Twenty-nine patients treated with weekly paclitaxel and 41 patients treated with paclitaxel/bevacizumab were identified. The groups were similar in demographics, initial optimal cytoreduction, stage, histology, grade, platinum sensitivity, and median number of previous regimens (4 vs. 4, p = 0.69).The overall response rate (ORR) was 63% (complete response (CR) 34% and partial response (PR) 29%) for paclitaxel/bevacizumab and 48% (CR 17% and PR 31%) for weekly paclitaxel (p = 0.23). Improvement in PFS was seen in those treated with paclitaxel/bevacizumab in comparison to weekly paclitaxel alone (median PFS 13.2 vs. 6.2 months, p < .01). There was a trend towards improved OS for paclitaxel/bevacizumab (median OS 20.6 vs. 9.1 months; p = 0.12). Toxicities were similar between the two regimens although more bowel perforations (2 vs. 0) were seen in the paclitaxel/bevacizumab group. Conclusion: A significant increase in PFS with a trend towards improved OS was demonstrated in this heavily pretreated population treated with paclitaxel/bevacizumab as compared to weekly paclitaxel alone. This data should be helpful in guiding future trials to determine the optimal care for women with recurrent EOC.

AB - Objective: Weekly paclitaxel has been shown to be an effective cytotoxic regimen for recurrent epithelial ovarian cancer (EOC), and may act through inhibition of angiogenesis. Bevacizumab, a potent angiogenesis inhibitor, has also been shown to have activity in patients with EOC. Therefore, we sought to determine if the addition of bevacizumab to weekly paclitaxel led to an increased survival compared to weekly paclitaxel alone. Methods: A single institutional review was conducted for patients with recurrent EOC treated with weekly paclitaxel (60-70 mg/m2) on days 1, 8, 15, and 22 of a 28 day cycle and those treated with weekly paclitaxel and bevacizumab (10-15 mg/kg on day 1 and 15). Response rates (RR) were calculated, and progression-free survival (PFS), and overall survival (OS) were compared using Kaplan-Meier survival analysis. Results: Twenty-nine patients treated with weekly paclitaxel and 41 patients treated with paclitaxel/bevacizumab were identified. The groups were similar in demographics, initial optimal cytoreduction, stage, histology, grade, platinum sensitivity, and median number of previous regimens (4 vs. 4, p = 0.69).The overall response rate (ORR) was 63% (complete response (CR) 34% and partial response (PR) 29%) for paclitaxel/bevacizumab and 48% (CR 17% and PR 31%) for weekly paclitaxel (p = 0.23). Improvement in PFS was seen in those treated with paclitaxel/bevacizumab in comparison to weekly paclitaxel alone (median PFS 13.2 vs. 6.2 months, p < .01). There was a trend towards improved OS for paclitaxel/bevacizumab (median OS 20.6 vs. 9.1 months; p = 0.12). Toxicities were similar between the two regimens although more bowel perforations (2 vs. 0) were seen in the paclitaxel/bevacizumab group. Conclusion: A significant increase in PFS with a trend towards improved OS was demonstrated in this heavily pretreated population treated with paclitaxel/bevacizumab as compared to weekly paclitaxel alone. This data should be helpful in guiding future trials to determine the optimal care for women with recurrent EOC.

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