Experience of using bevacizumab in epithelial ovarian, fallopian tube and primary peritoneal cancers in a single centre

Abstract

Objectives: To review the use of bevacizumab in epithelial ovarian, fallopian tube and primary peritoneal cancers in our centre. Methods: Patients receiving bevacizumab for epithelial ovarian, fallopian tube and primary peritoneal cancer at the Division of Gynaecological Oncology, Queen Mary Hospital, The University of Hong Kong between January 2011 and December 2015 were included. A retrospective chart review was performed. Main outcome measures were adverse events and progression-free survival. Results: Overall, 41 patients received bevacizumab for epithelial ovarian, fallopian tube or primary peritoneal cancer, of which 24 were for primary treatment and 17 for recurrent disease. Of 24 patients who received bevacizumab as primary treatment, the median age was 52 years, and 12.5% of the patients had early-stage high-risk disease, 87.5% had FIGO stage III or IV disease, 45.8% had a serous adenocarcinoma, and 54.2% had residual disease after debulking surgery. Of 17 patients who received bevacizumab for recurrent disease, the median age was 52 years, and 94.1% of the patients were having their first recurrence, 64.7% had platinum-sensitive disease and 41.2% had a serous adenocarcinoma. Grade 2 or higher hypertension and proteinuria occured in 24.4% and 12.2% of patients, respectively. Bevacizumab was discontinued in 7.3% of patients due to adverse events and 31.7% due to inadequate therapeutic response. The median progression free survival was 18.0 months (95% CI 13.6 to 22.4) for primary treatment and 11.0 months (95% CI 8.4 to 13.6) for recurrent disease. Conclusions: With acceptable toxicity, combination of bevacizumab and chemotherapy may be considered as treatment modality in newly diagnosed suboptimally debulked stage III or stage IV ovarian cancer as well as in recurrent ovarian cancer.