Jurado José Miguel, Sánchez Alfonso, Pajares Bella, Pérez Elisabeth, Alonso Lorenzo, Alba Emilio
Medical Oncology Service, Hospital Universitario Virgen de la Victoria, Málaga, Spain.
Clin Transl Oncol. 2008 Sep;10(9):583-6. doi: 10.1007/s12094-008-0254-7.
Metronomic chemotherapy combined with bevacizumab has proved to be effective in various tumour types. The aim of this study is to review our experience in recurrent ovarian carcinomas treated with low-dose cyclophosphamide and bevacizumab.
Retrospective analysis of pre-treated ovarian cancer patients, i.e., > or =2 previous chemotherapy regimens who received treatment with oral cyclophosphamide 50 mg/day and bevacizumab 10 mg/kg IV every two weeks. Patients with a performance status 0-2 were included. The endpoints were response rates, progressionfree disease and safety profile.
Nine patients with advanced, measurable ovarian cancer were included. Of these, 8 were platinum-resistant and had received prior regimens with gemcitabine (88%), topotecan (77%) and liposomal doxorubicin (66%). There was a mean of 5 previous lines of chemotherapy, range 2-7. Applying RECIST criteria, the efficacy data were as follows: objective response (OR) 44%; 4/9 (CR 2/9 and PR 2/9), SD 2/9 and DP 3/9. At 6 months, 33% of patients were progression free. Response lasted for 12.5 months in three patients treated for 12 months; a further two patients who were re-treated achieved complete response. Mean time to progression was 5.5 months (95% CI 4.5-5.5). No severe adverse effects were reported. Only one patient had to delay several cycles due to G3 haematuria. Other toxicities observed include G3 abdominal pain (1 case); G2 mucositis and G2 dyspnoea in one patient.
Combined bevacizumab and metronomic oral cyclophosphamide is a safe and effective regimen for heavily pre-treated ovarian cancer patients. Further research is needed on predictive factors to screen for those patients who will benefit from anti-angiogenic therapy.
节拍化疗联合贝伐单抗已被证明在多种肿瘤类型中有效。本研究的目的是回顾我们使用低剂量环磷酰胺和贝伐单抗治疗复发性卵巢癌的经验。
对预处理的卵巢癌患者进行回顾性分析，即接受过≥2种先前化疗方案的患者，这些患者接受口服环磷酰胺50mg/天和贝伐单抗10mg/kg静脉注射，每两周一次的治疗。纳入体能状态为0 - 2的患者。终点指标为缓解率、无进展生存期和安全性。
纳入9例晚期可测量的卵巢癌患者。其中，8例对铂耐药，之前接受过吉西他滨（88%）、拓扑替康（77%）和脂质体阿霉素（66%）的治疗方案。既往平均化疗线数为5，范围为2 - 7。应用RECIST标准，疗效数据如下：客观缓解（OR）44%；4/9（完全缓解2/9，部分缓解2/9），疾病稳定2/9，疾病进展3/9。6个月时，33%的患者无进展。3例接受12个月治疗的患者缓解持续时间为12.5个月；另外2例再次治疗的患者达到完全缓解。平均进展时间为5.5个月（95%CI 4.5 - 5.5）。未报告严重不良反应。仅1例患者因3级血尿不得不推迟几个周期。观察到的其他毒性包括3级腹痛（1例）；1例患者出现2级粘膜炎和2级呼吸困难。
贝伐单抗联合口服节拍环磷酰胺对预处理严重的卵巢癌患者是一种安全有效的方案。需要进一步研究预测因素，以筛选出那些将从抗血管生成治疗中获益的患者。
