Bevacizumab beyond progression: Impact of subsequent bevacizumab re-treatment in patients with ovarian, fallopian tube, and peritoneal cancer after progression

Abstract

Background

This study evaluated whether patients with epithelial ovarian, fallopian tube, and primary peritoneal carcinoma (OC) who are immediately re-treated with bevacizumab derive benefit after disease progression on a bevacizumab-containing regimen.

Methods

This multi-institutional, retrospective study compared patients with high grade non-mucinous epithelial OC who received bevacizumab followed directly by another bevacizumab-containing treatment regimen to patients who received bevacizumab followed by a regimen that did not contain bevacizumab (or received no further treatment). Progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan Meier product-limit estimator and modeled via Cox proportional hazards regression.

Results

Among 226 patients with OC who received bevacizumab as part of a treatment regimen,103 received sequential treatment with bevacizumab and 123 received a bevacizumab-containing regimen followed by a non-bevacizumab-containing regimen at the time of progression. Median follow-up for all subjects was 17.3 months (range, 1.2–138.2 months). Median PFS was 17.2 months (95 % CI, 14.3–21.2) for patients who received sequential bevacizumab re-treatment and 5.1 months (95 % CI, 4.3–6.3) for patients who received bevacizumab without bevacizumab-containing re-treatment (p < 0.001). Median OS was 29.9 months (95 % CI, 26.1–35.4) for patients who received sequential bevacizumab re-treatment (p < 0.001) and 12.4 months (95 % CI, 9.2–16.7) for patients who did not receive bevacizumab-containing re-treatment.

Conclusion

Patients with OC treated with bevacizumab-containing regimens sequentially at the time of progression have prolonged survival compared to patients who received no re-treatment with bevacizumab.