A recent study published in “The Lancet Oncology” reported that compared with carboplatin-based doublet (standard chemotherapy) alone, treatment with carboplatin-based double plus bevacizumab beyond disease progression substantially improves progression-free survival in ovarian cancer patients.
Investigators undertook this study to determine the benefit of continuing bevacizumab beyond progression after the first-line therapy with the same drug in females (age ≥18 years) suffering from ovarian cancer. These patients had been administered with first-line platinum-based therapy, including bevacizumab previously and experienced platinum-sensitive recurrent ovarian cancer.
The enrolled subjects were allocated to receive either the carboplatin-based doublet intravenously or carboplatin-based doublet plus bevacizumab. Investigator-evaluated progression-free survival, assessed on an intention-to-treat basis, was the significant outcome parameter. Drug safety was evaluated in all the participants who had received at least one dose.
Overall, 406 patients were divided into either the bevacizumab group (n=203) or the standard chemotherapy group (n=203). After receiving the last dose of platinum more than 12 months before, 130 individuals in the bevacizumab arm and 131 in the standard chemotherapy arm had progressed.
Also, 146 individuals in the bevacizumab arm and 147 in the standard chemotherapy arm had progressed after completing the first-line bevacizumab maintenance. In total, 161 participants progressed in the standard chemotherapy arm, as did 143 in the bevacizumab group.
In comparison with the standard chemotherapy arm, the median progression-free survival improved in the bevacizumab arm. The most commonly noted grade 3-4 side effects were hypertension and neutrophil and platelet count decline. One death in the bevacizumab group and two deaths in the standard chemotherapy arm were associated with therapy, as illustrated in Table.1 below:
|Bevacizumab group||Standard chemotherapy group|
|Median progression-free survival||11·8 months||8·8 months|
|Hypertension||58 (29%)||20 (10%)|
|Neutrophil count decrease||80 (40%)||81 (41%)|
|Platelet count decrease||61 (30%)||43 (22%)|
|Death||79 (39%)||68 (33%)|
Table 1: Comparison between bevacizumab vs the standard chemotherapy recipients
Thus, in individuals with ovarian cancer, continuing bevacizumab beyond progression in combination with standard chemotherapy improves progression-free survival and may be considered in medical practice.
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|Source||The Lancet Oncology|
|Original title of the article||Carboplatin-based doublet plus bevacizumab beyond progression versus carboplatin-based doublet alone in patients with platinum-sensitive ovarian cancer: a randomized, phase 3 trial|
|Authors:||Sandro Pignata et al.|