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Salvage bevacizumab (rhuMAB VEGF)-based therapy after multiple prior cytotoxic regimens in advanced refractory epithelial ovarian cancer.

Abstract Bevacizumab (BEV) is a humanized monoclonal antibody against vascular endothelial growth factor. We reviewed our experience with BEV in patients with recurrent advanced epithelial ovarian cancer who had failed multiple prior chemotherapeutic regimens.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title gynecologic oncology
Publication Year Start




PMID- 16790264
OWN - NLM
STAT- MEDLINE
DCOM- 20060829
LR  - 20151119
IS  - 0090-8258 (Print)
IS  - 0090-8258 (Linking)
VI  - 102
IP  - 2
DP  - 2006 Aug
TI  - Salvage bevacizumab (rhuMAB VEGF)-based therapy after multiple prior cytotoxic
      regimens in advanced refractory epithelial ovarian cancer.
PG  - 140-4
AB  - OBJECTIVES: Bevacizumab (BEV) is a humanized monoclonal antibody against vascular
      endothelial growth factor. We reviewed our experience with BEV in patients with
      recurrent advanced epithelial ovarian cancer who had failed multiple prior
      chemotherapeutic regimens. METHODS: Thirty-two patients not participating in an
      ongoing clinical trial were treated with BEV (15 mg/kg every 3 weeks IV).
      Demographic and clinicopathologic data, clinical outcomes, and adverse events
      were extracted from patient charts. RECIST and CA-125 Rustin criteria were
      retrospectively applied to evaluate response and progression. Median
      progression-free survival (PFS) and overall survival (OS) were determined using
      Kaplan-Meier methods. Adverse events were retrospectively categorized using the
      common terminology criteria for adverse events version 3. RESULTS: The median
      patient age was 57 years (range 35-80) with 84% being Caucasian and 50% having a 
      GOG performance status of 2. FIGO stages included 80% stage III and 10% stage IV.
      The tumors were mostly grades 2 (29%) and 3 (64%) and serous histological subtype
      (69%). All patients had failed multiple prior cytotoxic chemotherapies (median of
      5 (range 2-10)) prior to BEV. The median duration of follow-up was 4.8 months
      (range 0.4-16.3). Twenty-three patients were treated with BEV alone, 2 received
      BEV with another chemotherapy regimen (5-FU/lecovorin plus oxaliplatin,
      cyclophosphamide), and 8 initially received BEV alone, followed by BEV with
      capcitabine, cyclophosphamide, docetaxel, carboplatin, or weekly paclitaxel. A
      median of 6 cycles (range 1-20) with 196 total doses of BEV was administered. One
      patient was lost to follow-up after cycle 1. We observed a 16% response rate (all
      in those treated with BEV alone) with 62.5% of patients demonstrating stable
      disease. Median OS was 6.9 months, and the median PFS was 5.5 months. Three grade
      3 and no grade 4 adverse events were observed. Grade 3 toxicities included
      hypertension, proteinuria, and enterocutaneous fistula. The fistula occurred
      after 5 cycles of BEV in a patient who had undergone 7 debulking surgeries prior 
      to BEV. CONCLUSIONS: BEV is generally well tolerated after multiple prior
      cytotoxic regimens and results in significant clinical benefit among women with
      recurrent ovarian cancer.
FAU - Monk, Bradley J
AU  - Monk BJ
AD  - Division of Gynecologic Oncology, Chao Family Comprehensive Cancer Center,
      University of California-Irvine Medical Center, 1012 The City Drive, Orange, CA
      92868, USA. [email protected]
FAU - Han, Ernest
AU  - Han E
FAU - Josephs-Cowan, Carol A
AU  - Josephs-Cowan CA
FAU - Pugmire, Gordon
AU  - Pugmire G
FAU - Burger, Robert A
AU  - Burger RA
LA  - eng
GR  - K23 CA 92050/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20060621
PL  - United States
TA  - Gynecol Oncol
JT  - Gynecologic oncology
JID - 0365304
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 2S9ZZM9Q9V (Bevacizumab)
SB  - IM
CIN - Gynecol Oncol. 2006 Aug;102(2):131-3. PMID: 16846774
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antibodies, Monoclonal/*therapeutic use
MH  - Antibodies, Monoclonal, Humanized
MH  - Bevacizumab
MH  - Disease-Free Survival
MH  - Drug Resistance, Multiple
MH  - Drug Resistance, Neoplasm
MH  - Female
MH  - Humans
MH  - Middle Aged
MH  - Ovarian Neoplasms/*therapy
MH  - Salvage Therapy
EDAT- 2006/06/23 09:00
MHDA- 2006/08/30 09:00
CRDT- 2006/06/23 09:00
PHST- 2006/02/03 00:00 [received]
PHST- 2006/04/28 00:00 [revised]
PHST- 2006/05/03 00:00 [accepted]
PHST- 2006/06/23 09:00 [pubmed]
PHST- 2006/08/30 09:00 [medline]
PHST- 2006/06/23 09:00 [entrez]
AID - S0090-8258(06)00377-5 [pii]
AID - 10.1016/j.ygyno.2006.05.006 [doi]
PST - ppublish
SO  - Gynecol Oncol. 2006 Aug;102(2):140-4. doi: 10.1016/j.ygyno.2006.05.006. Epub 2006
      Jun 21.