Clinical benefit of bevacizumab in Mexican ovarian cancer patients according to the intention of treatment by the oncologist.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17097-e17097
Author(s):  
Dolores Gallardo-Rincon ◽  
Antonio Bahena-Gonzalez ◽  
Edgar Montes-Servín ◽  
Elizabeth Montes-Servín ◽  
David Michel-Tello ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Clinical Benefit ◽  
Gynecological Cancer ◽  
Line Treatment ◽  
Second Line ◽  
First Line ◽  
Debulking Surgery ◽  
Platinum Sensitive ◽  
Platinum Resistant ◽  
Venous Thromboembolic Events

e17097 Background: Ovarian cancer (OC) is the first cause of gynecological cancer, and the fifth cause of women cancer-death in US. In Mexico, more than 4,500 new cases of ovarian cancer are diagnosed yearly and it represents the second cause of gynecological cancer mortality. Bevacizumab (BVZ) is an antiangiogenic antibody that has been approved for first-line and recurrence therapy in OC patients. The aim of the study was to evaluate the clinical benefit of BVZ in different lines of treatment in Mexican OC patients. Methods: A total of 94 OC patients treated with BVZ were recruited at the Ovarian Cancer Program of the Instituto Nacional de Cancerología, from February 2012 to September 2018. Clinicopathological characteristics and toxicity was correlated with line of treatment. PFS curves were estimated by the Kaplan–Meier method, while comparisons among groups were analyzed with log-rank or Breslow tests. Results: Most of the patients were stage IIIC (69.1%) with HGSP histology (73.4%). 24 patients (25.5%) received BVZ as first-line treatment before debulking surgery (50% for suboptimal and 45.8% for optimal cytoreduction). 48 patients (51.1%) received BVZ for second-line (72.9% after a platinum-resistant and 27.1% after a platinum-sensitive recurrence) and 22 patients (23.4%) for three or more lines of treatment. Venous thromboembolic events (VTE) were more frequent in multi-treated patients ( P= 0.030). The median PFS was 23.7, 11.7 and 5.8 months for first, second and third or more lines, respectively. Patients with optimal debulking surgery had a better PFS compared with suboptimal and BVZ in first-line patients (24.8 vs 20.9; P= 0.050). Patients with BVZ in second-line who are a platinum-sensitive recurrence had better PFS compared to those with a platinum-resistant disease (15.1 vs 7.6; P= 0.040). Conclusions: OC patients had clinical benefit from treatment with BVZ when used as first-line and first recurrence treatments. The use of BVZ for third or later line treatment has a questionable benefit and is associated with a higher rate of VTE. Also, we highlight that 77% of the patients had the greatest-benefit while 33% had limited-benefit.

Recurrence patterns after bevacizumab in platinum-sensitive, recurrent epithelial ovarian cancer

2020 ◽  
Vol 30 (12) ◽  
pp. 1943-1950
Author(s):  
Se Ik Kim ◽  
Eun Ji Lee ◽  
Maria Lee ◽  
Hyunhoon Chung ◽  
Jae-Weon Kim ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Control Group ◽  
Study Group ◽  
Line Treatment ◽  
Second Line ◽  
Debulking Surgery ◽  
Platinum Sensitive ◽  
Free Interval ◽  
Recurrence Patterns

ObjectiveEvidence on recurrence patterns after bevacizumab in epithelial ovarian cancer is still insufficient. The aim of this study was to evaluate recurrence patterns after treatment with bevacizumab as second-line treatment in patients with platinum-sensitive, recurrent epithelial ovarian cancer.MethodsWe retrospectively identified epithelial ovarian cancer patients who relapsed ≥6 months after primary treatment consisting of surgery and platinum-based chemotherapy between January 2008 and June 2019. Only those who received platinum-based doublet chemotherapy with bevacizumab or without bevacizumab as second-line treatment were included (n=192). To adjust confounders, we conducted 1:2 propensity score matching for platinum-free interval and secondary debulking surgery. Imaging studies were performed to locate newly developed or enlarged pre-existing tumors. Recurrence patterns were compared between bevacizumab users (study group) and non-users (control group).ResultsAfter matching, the study group (n=52) and control group (n=104) showed similar baseline clinicopathologic characteristics including platinum-free interval (median (range) 15.3 (6.2–87.3) vs 14.0 (6.2–143.5) months; p=0.29) and patient age at the time of first recurrence (median (range) 55.5 (33.7–72.4) vs 55.0 (35.7–84.2) years; p=0.56). Initially, FIGO stage III disease was the most common in both two groups (55.8% vs 66.3%; p=0.20). Bevacizumab users were less likely to develop disease recurrence in the retroperitoneal lymph nodes (13.5% vs 34.6%; p=0.005), pelvis (17.3% vs 35.6%; p=0.018), and abdomen (40.4% vs 61.5%; p=0.012). However, no difference in distant metastasis was observed between the groups (23.1% vs 24.0%; p>0.99). Multivariate analyses adjusting for stage, histologic type, grade, platinum-free interval, and secondary debulking surgery revealed that the use of bevacizumab significantly reduced risks of nodal (adjusted HR (aHR) 0.24; 95% CI 0.10 to 0.56; p=0.001), pelvic (aHR 0.32; 95% CI 0.15 to 0.68; p=0.003), and abdominal recurrences (aHR 0.43; 95% CI 0.26 to 0.71; p=0.001). Nevertheless, use of bevacizumab did not influence risk of distant metastasis (aHR 0.70; 95% CI 0.35 to 1.40; p=0.32).ConclusionsIn patients with platinum-sensitive, recurrent epithelial ovarian cancer, second-line chemotherapy with bevacizumab is associated with reduced risks of nodal, pelvic, and abdominal recurrences, but similar risks of distant metastases.

Differences in Regional Diagnostic Strategies and in Intended Versus Actual First-Line Treatment of Patients With Advanced Ovarian Cancer in Denmark

2014 ◽  
Vol 24 (7) ◽  
pp. 1195-1205 ◽  
Author(s):  
Carsten Lindberg Fagö-Olsen ◽  
Bent Ottesen ◽  
Henrik Kehlet ◽  
Sofie Leisby Antonsen ◽  
Ib Jarle Christensen ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Gynecological Cancer ◽  
Advanced Ovarian Cancer ◽  
Diagnostic Process ◽  
Clinical Aspects ◽  
Diagnostic Strategy ◽  
Line Treatment ◽  
First Line ◽  
Debulking Surgery ◽  
First Line Treatment

BackgroundTriage of patients with ovarian cancer to primary debulking surgery (PDS) or neoadjuvant chemotherapy (NACT) is challenging. In Denmark, the use of NACT has increased, but substantial differences in the use of NACT or PDS exist among centers. We aimed to characterize the differences between intended and actual first-line treatments in addition to the differences in the triage process among the centers and to evaluate the different diagnostic modalities and the clinical aspects’ influence in the triage process.Materials and MethodsFrom 4 centers, forms containing data about the diagnostic process and intended treatment were prospectively collected and merged with data from the Danish Gynecological Cancer Database and medical records.ResultsOf the 671 completed forms, 540 patients had stage IIIC or IV epithelial ovarian cancer. Of the 238 (44%) referred to PDS, 91% received PDS and 4% never had debulking surgery. Of the 288 patients (53%) referred to NACT, 44% were never debulked. Fourteen patients (3%) were referred to palliative treatment. The use of different imaging modalities, diagnostic laparoscopy, and laparotomy varied significantly among the centers. Diagnostic surgical procedures were considered to be most influential in the triage process. Regardless of the intended first-line treatment or center, the tumor size and dissemination was the most influential clinical aspect.ConclusionsIn Denmark, substantial differences exist between intended and actual first-line treatments as well as in the diagnostic process and use of NACT, calling for further discussion on diagnostic strategy and therapeutically approach for patients with advanced ovarian cancer.

Multicenter Phase 2 Study of Combined Gemcitabine and Epirubicin as Second-Line Treatment for Patients With Advanced Ovarian Cancer

2010 ◽  
Vol 20 (6) ◽  
pp. 953-957 ◽  
Author(s):  
Viviana Murgia ◽  
Roberto Sorio ◽  
Claudia Griso ◽  
Orazio Caffo ◽  
Carmela Arcuri ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Performance Status ◽  
Eastern Cooperative Oncology Group ◽  
Advanced Ovarian Cancer ◽  
Hematological Toxicity ◽  
Line Treatment ◽  
Second Line ◽  
Phase 2 ◽  
Platinum Resistant ◽  
Gynecology And Obstetrics

Objective:The aim of this phase 2 trial was to evaluate the tolerability and efficacy of combined gemcitabine (G) and epirubicin (E) as second-line treatment for patients with advanced ovarian cancer.Methods:Treatment with G 1000 mg/m2 (days 1 and 8) and E 60 mg/m2 (day 1) every 3 weeks for 3 or, in the absence of progression, 6 courses.Results:Fifty patients with advanced ovarian cancer (31 serous, 2 endometrioid, 10 unclassified adenocarcinoma, and 7 other) and a median age of 60 years (range, 38-74 years) were enrolled after giving their informed consent. Performance status according to the Eastern Cooperative Oncology Group was 0 in 29 patients (58%), 1 in 17 patients (34%), and 2 in 4 patients (8%), and the initial stages according to the International Federation of Gynecology and Obstetrics were I to II in 4 patients (8%), III in 31 patients (62%), and IV in 15 patients (30%). They had previously received a median of 1.5 lines of treatment (range, 1-4). The median platinum-free interval was 5 months (range, 0-12 months): 32 patients had relapse within 6 months and 18 patients had relapse after 6 months.The response rate was 42% (2% complete response and 40% partial response), with a median duration of 7.2 months: the corresponding figures were 37.5% and 5.2 months in the platinum-resistant patients and 50% and 8.8 months in the platinum-sensitive patients. The main grade 3 to 4 hematological toxicity was neutropenia (56% of cases). After a median follow-up of 13.5 months, median progression-free survival was 5 months, and median overall survival was 23.5 months.Conclusions:This E + G combination seems to be active and safe in platinum-resistant/refractory patients.

scholarly journals Early clearance of serum HE4 and CA125 in predicting platinum sensitivity and prognosis in epithelial ovarian cancer

2020 ◽  
Author(s):  
Yan Rong ◽  
Li Li
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Clinical Data ◽  
First Line ◽  
Clinical Value ◽  
Platinum Sensitivity ◽  
Platinum Sensitive ◽  
Platinum Resistant ◽  
Line Chemotherapy ◽  
Sensitive Group

Abstract Objectives: To assess the clinical value of early clearance of HE4 and CA125 for platinum sensitivity and prognosis in patients with ovarian cancer.Method: HE4 and CA125 value including clinical data of 89 patients with ovarian cancer were collected. The clearance of HE4 and CA125 were assessed base on the platinum sensitivity, two-year PFS, PFS and OS.Results: 16 patients were classified as platinum resistant and 73 as platinum sensitive according to the response to platinum-base chemotherapy. When HE4 clearance after 3rd cycle chemotherapy or CA125 clearance after 1st cycle chemotherapy, it gave the highest AUC of 0.788, with 100% of sensitivity and 57.5% of specificity respectively between platinum resistant and platinum sensitive group. In addition, 59 patients were classified as two-year PFS group and 30 as not achieved two-year PFS group according to obtaining two-year PFS or not. It gave the highest AUC of 0.730, with 83.3% of sensitivity and 62.7% of specificity respectively when HE4 clearance after 3rd cycle chemotherapy or CA125 clearance after 1st cycle. The prolonged PFS and OS were significantly associated by the clearance of HE4 after 3rd cycle chemotherapy (p<0.0001, p<0.0001) as well as CA125 after 1st cycle chemotherapy (p<0.0001, p<0.0001).Conclusions: Our data suggested that the early clearance of HE4 and CA125 could predict platinum response and prognosis in patients with ovarian cancer. Monitoring the HE4 and CA125 during first-line chemotherapy might be helpful in predicting platinum sensitivity and risk to progress and relapse.

scholarly journals The Response of Second Line Chemotherapy Platinum Resistant Ovarian Cancer in Sudan: 2013-2017

2019 ◽  
Author(s):  
Mohammed Altyb Alshykh ◽  
Mohammed Elmujtba Adam Essa ◽  
Yousra Abdelmoniem Suleiman ◽  
Sherihan Mohammed Elkundi Osman ◽  
Mustafa Mohamed Ali Hussein ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Age Group ◽  
Second Line ◽  
Cancer Antigen 125 ◽  
First Line ◽  
Serous Adenocarcinoma ◽  
Cancer Antigen ◽  
Second Line Chemotherapy ◽  
Platinum Resistant ◽  
Line Chemotherapy

Abstract Background Ovarian carcinoma is the fifth leading cause of cancer death worldwide. The tumor mostly associated with variant factors such as advance age, early menstruation and gene association. We aimed to highlight the effectiveness of the second line chemotherapy in the management of ovarian cancer patients in Sudan.Methods The data were collected from the hospital patient’s records for five years period of time, included 62 patients with ovarian cancer who is treated by the second line platinum resistant chemotherapy.Result The peak prevalence of the patients was found in Al-Gazeera state, and the least in Al-Gadarif state. Age group above 55 years was the most affected group. The vast majority of patients showed partially mass disappearing, completes and continue growing tumor respectively. All patients received variant cycles of chemotherapy as fellow 3, 6, 2, 4, 5, 1 cycle respectively. 79.4% of the patients had achieved the normal value of cancer antigen 125 (CA125) levels after the treatment. In 50% of patients the cancer recurred after 1-2 months, 32.2% after 3-4 months and 17.8% after 5-6 months. The serous adenocarcinoma was found to be the most histological type in all the patients and the least two types were observed are cell carcinoma and serous papillary.Conclusion Our findings suggested that, Al-Gazeera state citizens were more vulnerable to resist the first line chemotherapy than others. The Sudanese patients with ovarian cancer may have better response to Gemzar.

scholarly journals The Response of Second Line Chemotherapy Platinum Resistant Ovarian Cancer in Sudan: 2013-2017

2019 ◽  
Author(s):  
Mohammed Altyb Alshykh ◽  
Mohammed Elmujtba Adam Essa ◽  
Yousra Abdelmoniem Suleiman ◽  
Sherihan Mohammed Elkundi Osman ◽  
Mutwaly Defealla Yousif Haron ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Recurrence ◽  
Disease Recurrence ◽  
Second Line ◽  
Cancer Antigen 125 ◽  
First Line ◽  
Serous Adenocarcinoma ◽  
Second Line Chemotherapy ◽  
Platinum Resistant ◽  
Line Chemotherapy

Abstract Background Ovarian carcinoma is the fifth leading cause of cancer death worldwide. The tumor mostly associated with variant factors such as advance age, early menstruation and gene association. We aimed to highlight the effectiveness of the second line chemotherapy in the management of ovarian cancer patients in Sudan. Methods The data were collected from the hospital patient’s records for five years period of time, included 62 patients with ovarian cancer who is treated by the second line platinum resistant chemotherapy. Result The peak prevalence of the patients was found in Aljazeera state, and the least in Algadarif state. Age group above 55 years was the most affected group. The vast majority of patients showed partially mass disappearing, completes and continue growing tumor respectively. All patients received variant cycles of chemotherapy as fellow 3, 6, 2, 4, 5, 1 cycle respectively. 79.4% of the patients had achieved the normal value of cancer antigen 125 (CA125) levels after the treatment. 50% of patients had 1-2 months interval time before the cancer recurrence, 32.2% had 3-4 months and 17.8% had 5-6 months before the disease recurrence. The serous adenocarcinoma was found to be the most histological type in all the patients and the least two types were observed are cell carcinoma and serous papillary. Conclusion Our findings suggested that, Aljazeera state citizens were more vulnerable to resist the first line chemotherapy than others. The Sudanese patients with ovarian cancer may have better response to Gemzar.

Second-Line Treatment with Intravenous Gemcitabine and Oral Etoposide in Platinum-Resistant Advanced Ovarian Cancer Patients: Results of a Phase II Study

Oncology ◽  
2011 ◽  
Vol 80 (3-4) ◽  
pp. 238-246 ◽  
Author(s):  
M. Bruzzone ◽  
M.G. Centurioni ◽  
P. Giglione ◽  
M. Gualco ◽  
D.F. Merlo ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Patients ◽  
Phase Ii ◽  
Phase Ii Study ◽  
Advanced Ovarian Cancer ◽  
Oral Etoposide ◽  
Line Treatment ◽  
Second Line ◽  
Platinum Resistant

scholarly journals Docetaxel and oxaliplatin in the second-line treatment of platinum-sensitive recurrent ovarian cancer: a phase II study

2007 ◽  
Vol 18 (8) ◽  
pp. 1348-1353 ◽  
Author(s):  
G Ferrandina ◽  
M Ludovisi ◽  
R De Vincenzo ◽  
V Salutari ◽  
D Lorusso ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Phase Ii ◽  
Phase Ii Study ◽  
Recurrent Ovarian Cancer ◽  
Line Treatment ◽  
Second Line ◽  
Platinum Sensitive

scholarly journals Early clearance of serum HE4 and CA125 in predicting platinum sensitive and prognosis in epithelial ovarian cancer

2020 ◽  
Author(s):  
Yan Rong ◽  
Li Li
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Clinical Data ◽  
First Line ◽  
Clinical Value ◽  
Platinum Sensitivity ◽  
Platinum Sensitive ◽  
Platinum Resistant ◽  
Line Chemotherapy ◽  
Sensitive Group

Abstract Objectives: To assess the clinical value of early clearance of HE4 and CA125 for platinum sensitive and prognosis in patients with ovarian cancerMethod: HE4 and CA125 value including clinical data of 89 patients with ovarian cancer were collected. The clearance of HE4 and CA125 were assessed base on the platinum sensitivity, two-year PFS, PFS and OS.Results: 16 patients were classified as platinum resistant and 73 as platinum sensitive according to the response to platinum-base chemotherapy. when HE4 clearance after 3rd cycle chemotherapy or CA125 clearance after 1st cycle chemotherapy, it gave the highest AUC of 0.788, with 100% of sensitivity and 57.5% of specificity respectively between platinum resistant and platinum sensitive group. In addition, 59 patients were classified as two-year PFS group and 30 as not achieved two-year PFS group according to obtaining two-year PFS or not. It gave the highest AUC of 0.730, with 83.3% of sensitivity and 62.7% of specificity respectively when HE4 clearance after 3rd cycle chemotherapy or CA125 clearance after 1st cycle. The prolonged PFS and OS were significantly associated by the clearance of HE4 after 3rd cycle chemotherapy (p < 0.0001, p < 0.0001) as well as CA125 after 1st cycle chemotherapy (p < 0.0001, p < 0.0001).Conclusions: Our data suggest that the early clearance of HE4 and CA125 could predict platinum response and prognosis in patients with ovarian cancer. Monitoring the HE4 and CA125 during first-line chemotherapy might be helpful in predicting platinum sensitive and risk to progress and relapse.

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