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Bevacizumab Shows Activity in Patients With Low-Grade Serous Ovarian and Primary Peritoneal Cancer

Grisham, Rachel N. MD*; Iyer, Gopa MD; Sala, Evis MD, PhD; Zhou, Qin MS§; Iasonos, Alexia PhD§; DeLair, Deborah MD; Hyman, David M. MD*; Aghajanian, Carol MD*

International Journal of Gynecological Cancer:
doi: 10.1097/IGC.0000000000000190
Ovarian Cancer
Abstract

Objective: Low-grade serous (LGS) ovarian and primary peritoneal cancer is a rare disease with limited therapeutic options. Low response rates are observed with cytotoxic chemotherapy. However, significant responses have been reported in patients treated with bevacizumab. The objective of this study was to determine the response rate to bevacizumab with or without concurrent chemotherapy in patients with recurrent serous borderline or LGS ovarian or primary peritoneal cancer.

Methods: This single-institution retrospective study examined the response rate to treatment with bevacizumab in patients with serous borderline or LGS cancer. Patients were treated at the Memorial Sloan Kettering Cancer Center between 2005 and 2012. The best overall response was determined with the use of the Response Evaluation Criteria in Solid Tumors.

Results: A total of 17 patients were identified, 15 of whom were evaluable for the primary end point of best overall response. Two patients were treated with bevacizumab as a single agent, and the remainder received bevacizumab in conjunction with chemotherapy (paclitaxel, topotecan, oral cyclophosphamide, gemcitabine, or gemcitabine and carboplatin). The median duration of bevacizumab administration in evaluable patients was 23 weeks (mean, 32.2 weeks; range, 6–79.4 weeks). There were no complete responses. Partial responses were observed in 6 patients (5 patients received concurrent paclitaxel, and 1 patient received concurrent gemcitabine). The overall response rate was 40%, with a response rate of 55% among the subgroup of patients with LGS cancer.

Conclusions: These results indicate that bevacizumab in combination with chemotherapy is an active treatment for recurrent LGS ovarian cancer. A prospective trial of bevacizumab in combination with paclitaxel for the treatment of LGS ovarian cancer should be considered.

Author Information

*Gynecologic Medical Oncology Service, Department of Medicine, †Human Oncology and Pathogenesis Program, ‡Department of Radiology, §Department of Epidemiology and Biostatistics, and ∥Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY.

Rachel Grisham and David Hyman are also both Instructor in Medicine at Weill Cornell Medical College, New York, NY.

Address correspondence and reprint requests to Rachel N. Grisham, MD, Memorial Sloan Kettering Cancer Center, 300 E 66th St, New York, NY, 10065. E-mail: gynbreast@mskcc.org.

Funded in part by the Ovarian Cancer Research Fund (291325), a Cycle for Survival grant, and the Cancer Center Core grant P30 CA008748. The core grant provides funding to institutional cores, such as biostatistics and pathology, which were used in this study.

The authors declare no conflicts of interest.

Received January 1, 2014

Accepted May 2, 2014

© 2014 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.