J Gynecol Oncol.  2016 Sep;27(5):e47. 10.3802/jgo.2016.27.e47.

Bevacizumab toxicity in heavily pretreated recurrent epithelial ovarian, fallopian tube, and primary peritoneal cancers

• Martin JY
• Urban RR
• Liao JB
• Goff BA

• KMID: 2374249
• DOI: http://doi.org/10.3802/jgo.2016.27.e47

Abstract

OBJECTIVE
Bevacizumab was recently approved by the US Food and Drug Administration for use in recurrent platinum resistant epithelial ovarian cancer (EOC), fallopian tube cancer (FTC), or primary peritoneal cancer (PPC) when no more than two prior cytotoxic regimens have been used; due to concerns for gastrointestinal perforation. We sought to determine bevacizumab-related toxicities in heavily pretreated recurrent EOC.
METHODS
We performed a retrospective chart review of patients with recurrent EOC, FTC, and PPC from 2001 to 2011. Patients who received at least two prior chemotherapy regimens before bevacizumab were included. Medical records were reviewed for bevacizumab associated toxicities. The Wilcoxon-Mann-Whitney test was used to compare quantitative variables. Survival was estimated with the Kaplan-Meier method.
RESULTS
Sixty patients met inclusion criteria. At the start of bevacizumab treatment, the median age was 60 years and the median body mass index was 26.5 kg/m². More than 50% of patients received bevacizumab after three prior cytotoxic regimens. Grade 3 or higher bevacizumab associated toxicity events occurred in four patients, including one patient who developed a rectovaginal fistula. The median overall survival from the start of bevacizumab treatment was 21.05 months (95% CI, 18.23 to 32.67; range, 1.9 to 110 months). The number of cytotoxic regimens prior to bevacizumab treatment did not differ in those that experienced a toxicity versus those that did not (p=0.66).
CONCLUSION
The use of bevacizumab in heavily pretreated EOC, FTC, or PPC is worth consideration.

Keyword

Bevacizumab; Drug Resistance; Gastrointestinal Diseases; Ovarian Neoplasms; Recurrence; Survival Analysis

MeSH Terms

Adult
Aged
Aged, 80 and over
Angiogenesis Inhibitors/*therapeutic use
Bevacizumab/*adverse effects
Fallopian Tube Neoplasms/*drug therapy
Female
Humans
Intestinal Perforation/chemically induced
Middle Aged
Neoplasm Recurrence, Local/*drug therapy
Neoplasms, Glandular and Epithelial/*drug therapy
Ovarian Neoplasms/*drug therapy
Peritoneal Neoplasms/*drug therapy
Retrospective Studies
Angiogenesis Inhibitors
Bevacizumab