Head-to-Head Trial Compares Bevacizumab/Platinum-Based Regimens in Recurrent Ovarian Cancer
Posted: Tuesday, June 9, 2020
Based on the findings of an international phase III trial published in The Lancet Oncology, bevacizumab in combination with carboplatin and pegylated liposomal doxorubicin may prove to be an effective therapeutic alternative for some patients with recurrent ovarian cancer. In fact, this novel regimen yielded longer progression-free survival than the standard carboplatin/gemcitabine/bevacizumab regimen, according to Jacobus Pfisterer, MD, PhD, of the Gynecologic Oncology Center, Kiel, Germany, and colleagues.
“These findings merit a more emphatic conclusion: that carboplatin-pegylated liposomal doxorubicin-bevacizumab should be the new standard of care, and clinicians need good reasons not to use it,” reported Richard T. Penson, MD, of Massachusetts General Hospital, Boston, in a related comment in The Lancet Oncology .
From 2013 to 2015, 682 patients with epithelial ovarian, primary peritoneal, or fallopian tube carcinoma who had a recurrence more than 6 months after first-line platinum-based chemotherapy were enrolled in the study. Patients were assigned to receive one of two combination therapies: bevacizumab, gemcitabine, and carboplatin (n = 337) every 3 weeks for six cycles or bevacizumab, carboplatin, and pegylated liposomal doxorubicin (n = 345) every 4 weeks for six cycles. Afterward, patients were administered maintenance bevacizumab every 3 weeks.
The researchers found that patients who received carboplatin/pegylated liposomal doxorubicin/bevacizumab had a mean progression-free survival of 13.3 months, compared with 11.6 months for those who received carboplatin/gemcitabine/bevacizumab (hazard ratio = 0.81, 95% confidence interval = 0.68–0.96, P = .012). Additionally, common adverse effects, including hypertension and neutropenia, were reported in 27% and 12%, respectively, with pegylated liposomal doxorubicin, and 20% and 22%, respectively, with gemcitabine. “As expected, the gemcitabine-containing standard regimen was associated with more grade 3 or worse adverse events,” the investigators commented. “However, fatal adverse events were infrequent in both groups.”
Disclosure: For full disclosures of the authors, visit thelancet.com.