Maurie Markman, MD


June 29, 2015

From the perspective of my practice, the most important study presented at the 2015 American Society of Clinical Oncology annual meeting was a phase 2 randomized trial conducted by investigators in Italy, who reported that the addition of bevacizumab (Avastin®) to carboplatin plus paclitaxel in patients with recurrent or primary advanced endometrial cancer improved both the objective response rate (72.7% vs 54.3%) and progression-free survival (median, 13.0 months vs 8.7 months; hazard ratio 0.57; P = .036).[1]

Although the study was underpowered to provide a definitive answer to the question (total sample size, 108 patients) of the overall clinical utility of this strategy in endometrial cancer, the data are consistent with extensive phase 3 trial results in ovarian cancer.

While it is uncertain whether third-party payers will accept the use of bevacizumab in this relatively uncommon situation, a strong argument can be made that in carefully selected patients (eg, good performance status, no serious comorbidities contraindicating the use of bevacizumab), the addition of this antiangiogenic agent to standard carboplatin/paclitaxel chemotherapy has a reasonable opportunity to favorably affect clinically relevant outcomes. It is important to acknowledge the development of hypertension and other vascular complications in this particular setting, as women with endometrial cancer are recognized to already have a relatively high incidence of cardiac comorbidities.


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