Cancer Therapy AdvisorDiscontinuation of Bevacizumab in Ovarian Cancer May Result in Rebound

Patients on bevacizumab showed significantly lower progression-free survival after stopping the medication than patients in the control group.

A recent study published in JAMA Network Open has shed light on the complex relationship between bevacizumab treatment and progression-free survival (PFS) in ovarian cancer patients. Although the drug initially prolongs PFS, discontinuation leads to a rebound in tumor growth, resulting in worse PFS compared to standard treatment. The research, encompassing data from seven phase 3 randomized clinical trials, reveals a nuanced picture of bevacizumab’s efficacy and potential risks.

Key Points:

• Bevacizumab initially prolonged PFS compared to standard treatment, but discontinuation led to worse PFS.
• Data was analyzed from seven phase 3 randomized clinical trials, including ICON7, GOG-0218, BOOST, GOG-0213, OCEANS, AURELIA, and MITO16B.
• In the ICON7-A cohort, no significant difference in PFS was found between bevacizumab and standard therapy groups (RMSTR, 1.07; 95% CI, 0.97-1.17; P =.16).
• Patients treated with bevacizumab had significantly longer PFS before discontinuation but worse PFS after discontinuation.
• Results varied based on histology and homologous recombination deficiency (HRD) status.

Additional Points:

• In patients with nonserous histology, PFS was improved with bevacizumab before discontinuation but not after.
• In serous ovarian cancer patients, PFS was inferior in the bevacizumab arm after discontinuation.
• No apparent rebound effect was observed in the GOG-0213, OCEANS, AURELIA, and MITO16B trials.

Conclusion:

• The study suggests that bevacizumab’s association with ovarian cancer progression varies over time, and it may be most useful for patients with an expected survival of less than 1 year.

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Did You Know?
Ovarian cancer ranks fifth in cancer deaths among women, accounting for more deaths than any other cancer of the female reproductive system. According to the American Cancer Society, a woman’s risk of getting ovarian cancer during her lifetime is about 1 in 78, and her risk of dying from ovarian cancer is about 1 in 108.