Ovarian Cancer Coverage from Every Angle

Bevacizumab for Ovarian Cancer: Final Overall Survival Analysis of GOG-0218

By: Sylvia O'Regan
Posted: Monday, August 26, 2019

Based on the final overall survival analysis of the phase III, randomized GOG-0218 trial of bevacizumab in women with newly diagnosed ovarian, fallopian tube, or primary peritoneal carcinoma, no survival differences were reported between patients who received bevacizumab and those who received chemotherapy alone. Krishnansu S. Tewari, MD, of the University of California, and colleagues added that testing for BRCA1/2 mutations and homologous recombination deficiency was essential in this patient population.

Between October 2005 and June 2009, the investigators evaluated 1,873 women with stage III to IV disease in the United States, Canada, South Korea, and Japan. The patients were randomly assigned cycles of either intravenous carboplatin, chemotherapy plus concurrent bevacizumab, or chemotherapy plus concurrent and maintenance bevacizumab. More than 1,000 serum and/or tumor specimens were sequenced for BRCA1/2 and damaging mutations in homologous recombination repair genes. Overall survival was also assessed.

“Disease-specific survival was not improved in any arm,” the investigators said. “No survival advantage was observed after censoring patients who received bevacizumab at crossover or as second line.”

The median follow-up was 102.9 months, and there were 493 deaths in the control arm. The median postprogression survival for patients in the bevacizumab-concurrent arm was 22.3 months, compared with 20.1 months for those in the control arm and 23.7 months for patients treated with bevacizumab-concurrent plus maintenance. The hazard ratio for death for BRCA1/2-mutated carcinomas was 0.62, and it was 0.65 for non-BRCA1/2 homologous recombination repair tumors. The investigators said the latter results, although clearly prognostic, were not predictive of bevacizumab activity.

“Although the prognostic impact of BRCA1/2 mutations generally has been accepted, this randomized trial is the first in our knowledge to demonstrate the effect so clearly,” they added.

Disclosure: The study authors’ disclosure information may be found at ascopubs.org.

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