J Gynecol Oncol.  2024 Nov;35(6):e76. 10.3802/jgo.2024.35.e76.

A retrospective study of dose-dense paclitaxel and carboplatin plus bevacizumab as first-line treatment of advanced epithelial ovarian cancer

• Komazaki H
• Takahashi K
• Tanabe H
• Shoburu Y
• Kamii M
• Tsuda A
• Saito M
• Yamada K
• Takano H
• Michimae H
• Okamoto A

• KMID: 2564971
• DOI: http://doi.org/10.3802/jgo.2024.35.e76

Abstract

Objective
This study compared the effectiveness, safety, and tolerability of dose-dense paclitaxel and carboplatin plus bevacizumab (ddTC+Bev) with ddTC for advanced ovarian cancer.
Methods
We retrospectively analyzed the clinical records of 134 patients who received ddTC+Bev or ddTC as first-line chemotherapy for stage III–IV ovarian cancer. Progressionfree survival as primary endpoint of this study was compared using the log-rank test. Cox proportional hazards model and propensity score matching (PSM) were used to analyze prognostic factors, and the frequency of adverse events was examined using the χ 2 test.
Results
We categorized 134 patients in the ddTC+Bev (n=57) and ddTC (n=77) groups who started treatment at four related institutions from November 2013 to December 2017. No patients used poly (ADP-ribose) polymerase inhibitors as the first line maintenance therapy. The progression-free survival (PFS) of the ddTC+Bev group had a significantly better prognosis than that of the ddTC group (hazard ratio [HR]=0.50; 95% confidence interval [CI]=0.32–0.79; p<0.003). Multivariate analysis showed that ddTC+Bev regimen was a prognostic factor. However, intergroup comparison using PSM revealed that the PFS of the ddTC+Bev group had a nonsignificantly better prognosis than that of the ddTC group (HR=0.70; 95% CI=0.41–1.20; p=0.189). Few adverse events above G3 were noted for ddTC+Bev, which were sufficiently tolerable.
Conclusion
This study could not demonstrate that adding Bev to ddTC improves prognosis. Further studies with more cases are warranted.

Keyword

Ovarian Neoplasms; Paclitaxel; Bevacizumab; Angiogenesis; Drug Therapy