COMMENTARY

Bevacizumab Shows Activity in Rare Ovarian Cancer

Rachel N. Grisham, MD

Disclosures

June 17, 2013

Bev Plus Chemo Equals Better Response

Given the previously reported results of bevacizumab for treatment of recurrent epithelial ovarian cancer, we chose to retrospectively study our population of low-grade serous and serous borderline patients treated with bevacizumab for recurrent disease and then evaluate for their response rate.[1]

Between 2005 and 2012, a total of 17 patients with serous borderline or low-grade serous ovarian cancer were treated at Memorial Sloan-Kettering Cancer Center with bevacizumab for recurrent or persistent disease. Those 17 patients included 10 women with low-grade serous ovarian cancer, 3 women with low-grade serous primary peritoneal cancer, and 4 women with serous borderline disease. Most patients were treated with bevacizumab in combination with chemotherapy. Two patients were treated with bevacizumab alone, and the remaining 15 patients received bevacizumab in combination with some type of chemotherapy. The most common chemotherapy administered in combination with bevacizumab was paclitaxel.

All responses were confirmed by a radiologist for response rate by RECIST 1.1 criteria. The pathology was confirmed by a gynecologic pathologist. The results showed that we had no complete responses. However, partial responses were seen in 6 patients, giving a response rate of 40%. Furthermore, 33.3% of patients achieved stable disease as their best response, giving an overall clinical benefit rate of 73.3%. Although these numbers are small, this response rate is significantly higher than what has previously been reported for responses to single-agent chemotherapy in this disease.

Although data are scarce, previous case reports of patients with serous borderline disease show a favorable response to treatment with bevacizumab. Moreover, Schmeler and others[7] reported an abstract in conjunction with ASCO 2010 which looked at 17 patients treated at MD Anderson Cancer Center for recurrent low-grade serous ovarian cancer. Those patients were treated with bevacizumab in combination with some type of chemotherapy. They reported a response rate of 39%, which is quite similar to the response rate that we reported here.

Although the number of patients we looked at is small, our data suggest that the addition of bevacizumab to standard chemotherapy offers a promising treatment strategy for women with recurrent low-grade serous ovarian cancer. My colleagues and I feel that a prospective trial is warranted.

Thank you for joining me for this edition of Medscape Oncology Insights. This is Rachel Grisham at ASCO 2013.

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