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Retreatment with bevacizumab in patients with gynecologic malignancy is associated with clinical response and does not increase morbidity
PURPOSE: Bevacizumab (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 t...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3968081/ https://www.ncbi.nlm.nih.gov/pubmed/24711703 http://dx.doi.org/10.2147/OTT.S57425 |
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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 |
author_facet | 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 |
author_sort | Laskey, Robin A |
collection | PubMed |
description | PURPOSE: Bevacizumab (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 METHODS: Women 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. RESULTS: Of 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. CONCLUSION: Retreatment 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. |
format | Online Article Text |
id | pubmed-3968081 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-39680812014-04-07 Retreatment with bevacizumab in patients with gynecologic malignancy is associated with clinical response and does not increase morbidity 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 Onco Targets Ther Original Research PURPOSE: Bevacizumab (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 METHODS: Women 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. RESULTS: Of 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. CONCLUSION: Retreatment 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. Dove Medical Press 2014-03-21 /pmc/articles/PMC3968081/ /pubmed/24711703 http://dx.doi.org/10.2147/OTT.S57425 Text en © 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 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. |
spellingShingle | Original Research 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 Retreatment with bevacizumab in patients with gynecologic malignancy is associated with clinical response and does not increase morbidity |
title | Retreatment with bevacizumab in patients with gynecologic malignancy is associated with clinical response and does not increase morbidity |
title_full | Retreatment with bevacizumab in patients with gynecologic malignancy is associated with clinical response and does not increase morbidity |
title_fullStr | Retreatment with bevacizumab in patients with gynecologic malignancy is associated with clinical response and does not increase morbidity |
title_full_unstemmed | Retreatment with bevacizumab in patients with gynecologic malignancy is associated with clinical response and does not increase morbidity |
title_short | Retreatment with bevacizumab in patients with gynecologic malignancy is associated with clinical response and does not increase morbidity |
title_sort | retreatment with bevacizumab in patients with gynecologic malignancy is associated with clinical response and does not increase morbidity |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3968081/ https://www.ncbi.nlm.nih.gov/pubmed/24711703 http://dx.doi.org/10.2147/OTT.S57425 |
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