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Antiangiogenic Therapy Should be Considered Standard Treatment in the Adjuvant Therapy of Epithelial Ovarian Cancer

  • Controversies in Gynecological Cancers
  • Published:
Indian Journal of Gynecologic Oncology Aims and scope Submit manuscript

Abstract

Angiogenesis is an important driver of growth and metastasis. Preclinical studies in epithelial ovarian cancer have shown the association between increased angiogenesis and poor prognosis. More than 10 years ago, single-agent bevacizumab (BV) was found to have activity in advanced ovarian cancer. Since then multiple randomized clinical trials have shown improvements in clinically relevant outcomes, especially, progression-free survival (PFS). The most important evidence supporting adjuvant use of BV came from the GOG 218 and ICON 7 trials. Both trials showed improvements in PFS with a higher magnitude of benefit for those with high-risk disease, i.e., Stage IV, inoperable and suboptimally debulked Stage III disease. Use of BV was also associated with an improvement in overall survival in these high-risk subgroups. The EMEA has recommended use of BV in the adjuvant setting, and the ESMO has endorsed its use in high-risk subgroups. Though there is a small detriment in the quality of life with addition of BV, this is not clinically significant. Based on the available efficacy data and approval by regulatory bodies, BV is recommended for adjuvant treatment of advanced epithelial ovarian cancer. The search for a predictive marker has remained elusive. The data for antiangiogenic agents other than BV are scant. Many more agents are in early stages of clinical development.

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  1. Basavatarakam Indo American Cancer Hospital and Research Institute, Road No: 10 Banjara Hills, Hyderabad, 500034, India

    Senthil J. Rajappa

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  1. Senthil J. Rajappa
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Correspondence to Senthil J. Rajappa.

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Rajappa, S.J. Antiangiogenic Therapy Should be Considered Standard Treatment in the Adjuvant Therapy of Epithelial Ovarian Cancer. Indian J Gynecol Oncolog 15 (Suppl 1), 3–7 (2017). https://doi.org/10.1007/s40944-017-0151-z

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  • DOI: https://doi.org/10.1007/s40944-017-0151-z

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