COMMENTARY

How Does Bevacizumab Plus Chemotherapy Perform in 'Real World' Platinum-Resistant Recurrent Ovarian Cancer?

Maurie Markman, MD

Disclosures

February 28, 2019

This transcript has been edited for clarity.

Hello, I'm Dr Maurie Markman from Cancer Treatment Centers of America in Philadelphia. An interesting paper recently appeared in Gynecologic Oncology, titled "Real-World Effectiveness of Bevacizumab Based on AURELIA in Platinum-Resistant Recurrent Ovarian Cancer (REBECA): A Korean Gynecologic Oncology Group Study (KGOG 3041)."[1]

This paper is interesting because it addresses the question of what happens in the real world when a result from a randomized phase 3 trial sort of changes the paradigm and the management of cancer. It's spectacular, of course, to see that kind of result. In fact, bevacizumab was approved in combination with chemotherapy for treatment of platinum-resistant ovarian cancer based on this trial. But is it real? Were the patients highly selected [in the trial]? What happens when you treat a large number of patients outside of the study setting?

This retrospective review looked at almost 400 patients with platinum-resistant ovarian cancer treated at 27 different institutions. The investigators demonstrated an improvement in progression-free survival (PFS) of 6.1 months in the experimental arm [receiving bevacizumab]. There was apparent activity with the three chemotherapy drugs [given as single-agent chemotherapy with bevacizumab] used in the trial: topotecan, pegylated liposomal doxorubicin, or paclitaxel. Toxicity was acceptable. These results were highly impressive and provocative.

Again, these patients were treated in the nonresearch setting. The data would suggest that this combination of chemotherapy and bevacizumab in platinum-resistant ovarian cancer in fact works outside of the clinical trial setting. In other words, a clinical benefit is observed.

For those of you interested in ovarian cancer and in real-world data, I would encourage you to look at this very interesting paper that just appeared in Gynecologic Oncology. I thank you for your attention.

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