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Bevacizumab in recurrent ovarian cancer: could it be particularly effective in patients with clear cell carcinoma?

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Abstract

Purpose

Treatment of recurrent ovarian carcinoma is a challenge, particularly for the clear cell (CCC) subtype. However, there is a preclinical rationale that these patients could achieve a benefit from antiangiogenic therapy. To assess this hypothesis, we used the growth modulation index (GMI), which represents an intrapatient comparison of two successive progression-free survival (PFS).

Methods

We conducted a retrospective real-world study performed on 34 patients with recurrent ovarian cancer, treated with bevacizumab-containing regimens from January 2009 to December 2017. The primary endpoint was GMI. An established cut-off > 1.33 was defined as a sign of drug activity.

Results

73.5% of patients had high-grade serous ovarian carcinoma (HGSOC), and 17.7% had CCC; 70.6% of patients received carboplatin/gemcitabine/bevacizumab, and 29.4% received weekly paclitaxel/bevacizumab. According to histological subtype, the overall response rate and median PFS were 52% and 14 months for HGSOC and 83.3% and 20 months for CCC, respectively. The overall population median GMI was 0.99; it was 0.95 and 2.36 for HGSOC and CCC, respectively. CCC subtype was significantly correlated with GMI > 1.33 (odds ratio 41.67; 95% confidence interval 3.6–486.94; p = .03).

Conclusion

Adding bevacizumab to chemotherapy in recurrent CCC is associated with a remarkable benefit in this cohort. The efficacy of antiangiogenic drugs in CCC warrants further prospective evaluation.

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Availability of data and material

We will provide our data for the reproducibility of this study in other centers if such is requested.

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Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Author notes

  1. A. Gallego and J. Ramon-Patino contributed equally to this manuscript.

Authors and Affiliations

  1. Department of Medical Oncology, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain

    A. Gallego, B. Castelo, E. Espinosa, J. Feliu & A. Redondo

  2. Translational Oncology Research Laboratory, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain

    A. Gallego, J. Ramon-Patino, B. Castelo, E. Espinosa, J. Feliu & A. Redondo

  3. Department of Medical Oncology, Instituto Catalán de Oncología, Hospitalet de Llobregat, Barcelona, Spain

    J. Brenes

  4. Molecular Pathology and Therapeutic Targets Group, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain

    M. Mendiola, A. Berjon & D. Hardisson

  5. Center for Biomedical Research in the Cancer Network (Centro de Investigación Biomédica en Red de Cáncer, CIBERONC), Instituto de Salud Carlos III, Madrid, Spain

    M. Mendiola, E. Espinosa, D. Hardisson & J. Feliu

  6. Department of Pathology, Hospital Universitario La Paz, Madrid, Spain

    A. Berjon & D. Hardisson

  7. Department of Pharmacy, Hospital Universitario La Paz, Madrid, Spain

    G. Casado

  8. Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain

    B. Castelo, E. Espinosa, A. Hernandez, D. Hardisson, J. Feliu & A. Redondo

  9. Cátedra Universidad Autónoma de Madrid UAM-Amgen, Madrid, Spain

    B. Castelo, E. Espinosa, J. Feliu & A. Redondo

  10. Department of Gynecology, Hospital Universitario La Paz, Madrid, Spain

    A. Hernandez

Authors
  1. A. Gallego
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  2. J. Ramon-Patino
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  3. J. Brenes
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  4. M. Mendiola
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  5. A. Berjon
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  6. G. Casado
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  7. B. Castelo
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  8. E. Espinosa
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  9. A. Hernandez
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  10. D. Hardisson
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  11. J. Feliu
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  12. A. Redondo
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Contributions

Conceptualization: AR, AG, JR-P, JB; data collection: JB, AG, JR-P; data analysis: JR-P, JB, AG; writing—original draft preparation: AG, JR-P, AR; writing—review and editing: MM, AB, GC, BC, EE, AH, DH, JF, AR; supervision: AR.

Corresponding author

Correspondence to A. Redondo.

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Conflict of interest

AG reports honoraria and advisory/consultancy (Pharmamar), travel/accommodation/expenses (Roche, Tesaro-GSK, Pierre-Fabre, Pharmamar, MSD), speakers bureau (Roche, Clovis, Astra Zeneca, MSD), outside the submitted work. EE reports personal fees from Roche, outside the submitted work. JF reports advisory/consultancy (Amgen, Ipsen, Eisai, Merck, Roche, Novartis) and others (Amgen), outside the submitted work. AR reports honoraria and advisory/consultancy (AstraZeneca, Roche, Tesaro, Clovis, PharmaMar, Lilly, Amgen), honoraria (Eisai), research grant/funding to institution (Eisai, PharmaMar, Roche), travel/accommodation/expenses (AstraZeneca, Tesaro, PharmaMar, Roche), and others (Amgen), outside the submitted work. The remaining authors (JR-P, JB, MM, AB, GC, BC, AH, DH) have declared no conflicts of interest.

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The study was approved by local Ethics Committee.

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Gallego, A., Ramon-Patino, J., Brenes, J. et al. Bevacizumab in recurrent ovarian cancer: could it be particularly effective in patients with clear cell carcinoma?. Clin Transl Oncol 23, 536–542 (2021). https://doi.org/10.1007/s12094-020-02446-z

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  • DOI: https://doi.org/10.1007/s12094-020-02446-z

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