IV Versus IP Chemotherapy Plus Bevacizumab in Advanced Ovarian Cancer
Posted: Tuesday, May 28, 2019
Compared with intravenous (IV) administration, intraperitoneal (IP) chemotherapy with bevacizumab does not seem to improve progression-free survival in women with advanced ovarian cancer. This finding, based on an NRG Oncology/Gynecologic Oncology Group study, by Joan L. Walker, MD, of the University of Oklahoma Health Sciences Center, and colleagues was published in the Journal of Clinical Oncology.
“Compared with the IV carboplatin reference arm, the duration of [progression-free survival] was not significantly increased with either IP regimen,” the authors concluded.
In this multicenter, open-label, phase III trial, 1,560 women with ovarian, fallopian, or primary peritoneal cancer were randomly assigned to receive IP carboplatin, IV carboplatin (control), or IP cisplatin. Of these patients, 1,380 had optimally resected, advanced cancers. All patients received paclitaxel and bevacizumab.
In those with optimally resected, advanced cancer, the progression-free survival rates were similar in the control, IP carboplatin, and IP cisplatin treatments (26.9, 28.7, and 27.8 months, respectively). The progression-free survival rates were also similar among patients with advanced cancer and no residual disease after surgery (35.9, 38.8, and 36.5 months, respectively). Overall, the median progression-free survival rates were 24.9, 27.4, and 26.2 months, respectively.
Grade 3 or worse infections were higher in the IP groups (P = .008), and grade 3 nausea and hypertension were higher in the IP cisplatin group. Further research is needed to determine the optimal maintenance strategy in this population as well as whether bevacizumab interacts with chemotherapy.
Disclosure: The study authors’ disclosure information may be found at ascopubs.org.