Retreatment with bevacizumab in patients with gynecologic malignancy is associated with clinical response and does not increase morbidity.

Content Provider	Europe PMC
Author	Laskey, Robin A Richard, Scott D Smith, Ashlee L Lin, Jeff F Beck, Tiffany L Lesnock, Jamie L Kelley, Joseph L Olawaiye, Alexander B Sukumvanich, Paniti Krivak, Thomas C
Copyright Year	2014
Abstract	PurposeBevacizumab (Bev) is associated with improved progression-free survival in advanced epithelial ovarian cancer. The use of Bev in patients with gynecologic malignancy is increasing; however, little is known about cumulative toxicity and response in patients retreated with Bev. Our goal was to determine cumulative side effects and response in patients retreated with Bev.Patients and methodsWomen with recurrent gynecologic malignancy treated with Bev between January 2007 and March 2012 at a single institution were identified, including a subset who received Bev in a subsequent regimen. The primary outcome was Bev-associated toxicity, and the secondary outcome was response.ResultsOf 83 patients that received Bev for recurrent disease, 23 were retreated with Bev and four received Bev maintenance. Three patients (13%) developed grade 3 or 4 hypertension; all had a history of chronic hypertension. One (4.3%) patient developed grade 3 proteinuria, and one (4.3%) developed an enterovaginal fistula. Four patients discontinued Bev secondary to toxicity. Toxicity was not related to the cumulative number of cycles. Twenty-six percent of patients responded to Bev retreatment. On univariate analysis, there was a significant (P=0.003) overall survival advantage when the Bev-free interval was >9 months (95% confidence interval [CI] 4.9–43.7) compared to ≤9 months (95% CI 2.1–11.5), 24.3 months, and 6.8 months.ConclusionRetreatment of patients with recurrent gynecologic malignancy with Bev did not increase morbidity and was associated with treatment response. Physicians treating women with recurrent disease may consider a Bev-containing regimen even if prior regimen(s) included Bev. Future studies should prospectively evaluate the efficacy of this treatment strategy.
Journal	Oncotargets and Therapy
Volume Number	7
PubMed Central reference number	PMC3968081
PubMed reference number	24711703
e-ISSN	11786930
DOI	10.2147/ott.s57425
Language	English
Publisher	Dove Medical Press
Publisher Date	2014-03-21
Access Restriction	Open
Rights License	The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. © 2014 Laskey et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License
Subject Keyword	bevacizumab gynecologic malignancy cumulative toxicity treatment response
Content Type	Text
Resource Type	Article
Subject	Pharmacology (medical) Oncology