IMR Press / EJGO / Volume 42 / Issue 6 / DOI: 10.31083/j.ejgo4206174
Open Access Original Research
The effect of bevacizumab maintenance therapy on survival in recurrent epithelial ovarian cancer
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1 Department of Gynecology Obstetrics, Division of Gynecologic Oncology, Akdeniz University, 07070 Antalya, Turkey
Eur. J. Gynaecol. Oncol. 2021, 42(6), 1198–1204; https://doi.org/10.31083/j.ejgo4206174
Submitted: 4 April 2021 | Revised: 29 April 2021 | Accepted: 12 May 2021 | Published: 15 December 2021
Copyright: © 2021 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
Abstract

Objective: We aimed to present our own retrospective data about the effectiveness of Bevacizumab (BV) maintenance therapy on survival to achieve optimal treatment in recurrent ovarian cancer. Methods: The data of patients with recurrent ovarian, tubal, and primary peritoneal cancer presenting to our hospital between October 2008 and December 2019 were retrospectively gathered from the hospital’s electronic archive system. The patients were grouped according to the platinum-free interval state. The patients were divided into two groups of BV maintenance and no BV maintenance and their progression-free and overall survival were calculated. Results: A total of 65 patients with recurrent epithelial ovarian cancer were included in the study. Among these, 35 had received bevacizumab therapy alone and 30 received bevacizumab maintenance therapy. According to the platinum-free interval, 37 of the patients had platinum-sensitive recurrent epithelial ovarian cancer and the remaining 28 had platinum-resistant recurrent epithelial ovarian cancer. The median follow-up was 42 (min: 13–max: 135) months. The average age was 56.5 ± 9.1 in the no bevacizumab maintenance group and 57.5 ± 9.6 in the bevacizumab maintenance group (p: 0.812). Among the platinum-sensitive recurrent epithelial ovarian cancer patients, the median progression-free survival progression-free survival (PFS) was 8 months (95% Confidence Interval (CI); 5.7–10.2) in the no bevacizumab maintenance group and 22 months (95% CI; 18.9–24.1) (p: 0.001) in the bevacizumab maintenance group and for the bevacizumab maintenance patients Hazard Ratio (HR): 0.10 (95% CI; 0.03–0.27) (p: 0.001). While the median overall survival (OS) of platinum-sensitive recurrent epithelial ovarian cancer patients in the no bevacizumab maintenance group was 64 months (95% CI; 21.6–102.3), it was 86 months (95% CI; NA) (p: 0.155) in the group that received bevacizumab maintenance, and for patients who received bevacizumab maintenance therapy, HR: 0.55 (95% CI; 0.18–1.33) (p: 0.166). The median PFS for platinum-resistant recurrent epithelial ovarian cancer patients who received no bevacizumab maintenance was determined as 7 (95% CI; 4.8–9.1) and as 19 months (95% CI; 9.2–26.7) (p: 0.009) for patients who received bevacizumab maintenance therapy, and for patients who received BV maintenance therapy, HR: 0.17 (95% CI; 0.03–0.71) (p: 0.022). In terms of OS, the median OS of platinum-resistant recurrent epithelial ovarian cancer patients who received no bevacizumab maintenance was 34 (95% CI; 31.5–36) months, while it was 45 (95% CI; 42.5–47.4) months in patients who received bevacizumab maintenance (p: 0.231); the HR for death in patients receiving bevacizumab maintenance therapy: 0.50 (95% CI; 0.15–1.61) (p: 0.247). Discussion: While it was shown that bevacizumab maintenance therapy had a significant effect on progression-free survival in both platinum-sensitive and platinum-resistant ovarian cancer, this effect could not be demonstrated for overall survival. Despite this, bevacizumab maintenance therapy can be delivered in recurrent ovarian cancer in addition to standard therapy. Further studies about its effect on overall survival are required.

Keywords
Recurrent epithelial ovarian cancer
Platinum-sensitive
Platinum-resistant
Bevacizumab maintenance
Survival
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