Abaid L N, Lopez K L, Micha J P, Rettenmaier M A, Brown J V, Goldstein B H
Gynecologic Oncology Associates, Hoag Cancer Center, Newport Beach, CA 92663, USA.
Eur J Gynaecol Oncol. 2010;31(3):308-11.
The purpose of this preliminary study was to retrospectively assess the incidence of bowel perforation and hypertension in two separate advanced ovarian cancer patient populations following first-line therapy, comprising paclitaxel, carboplatin and bevacizumab. The first 20 patients were treated with six cycles of paclitaxel (175 mg/m2), carboplatin (AUC of 5 i.v.), and bevacizumab (15 mg/kg of body weight); q21 days per an independent protocol. The subsequent patients (n = 12) were administered weekly paclitaxel (80 mg/m2), carboplatin (AUC of 5 i.v.) every four weeks, and bevacizumab (10 mg/kg of body weight) every two weeks for six cycles according to a separate, independent protocol. Bevacizumab was not added to either chemotherapy regimen until cycle 2. In both groups patients who achieved a complete response, partial response or stable disease at the conclusion of induction therapy received bevacizumab (10 mg/kg) and paclitaxel (135 mg/m2) q21 days as maintenance therapy. A total of 170 cycles (median = 6; range 3-6) of primary induction chemotherapy, 140 of which contained bevacizumab, were administered. Moreover, 206 cycles (median = 9; range 1-12) of maintenance chemotherapy have been delivered to 28 patients thus far. There was no incidence of GI perforation and only two patients demonstrated clinically significant hypertension. Previous studies involving bevacizumab have raised concerns regarding bowel perforations and hypertension. However, we did not encounter difficulties with either of these complications. While we recognize that the risk for bowel perforation remains in the 5-11% range, the study's preliminary results suggest that first-line treatment of advanced stage ovarian carcinoma with bevacizumab can be safely administered.
本初步研究的目的是回顾性评估在接受一线治疗（包括紫杉醇、卡铂和贝伐单抗）后的两个不同的晚期卵巢癌患者群体中肠穿孔和高血压的发生率。前20例患者接受六个周期的紫杉醇（175mg/m²）、卡铂（静脉注射AUC为5）和贝伐单抗（15mg/kg体重）治疗；按照独立方案每21天给药一次。随后的患者（n = 12）根据另一个独立方案，每周给予紫杉醇（80mg/m²），每四周给予卡铂（静脉注射AUC为5），每两周给予贝伐单抗（10mg/kg体重），共六个周期。直到第2周期才将贝伐单抗添加到任何一种化疗方案中。在两组中，诱导治疗结束时达到完全缓解、部分缓解或疾病稳定的患者接受贝伐单抗（10mg/kg）和紫杉醇（135mg/m²）每21天一次作为维持治疗。共进行了170个周期（中位数 = 6；范围3 - 6）的一线诱导化疗，其中140个周期包含贝伐单抗。此外，到目前为止，已对28例患者进行了206个周期（中位数 = 9；范围1 - 12）的维持化疗。未发生胃肠道穿孔，仅有两名患者出现临床显著的高血压。先前涉及贝伐单抗的研究引发了对肠穿孔和高血压的担忧。然而，我们并未遇到这两种并发症中的任何一种的问题。虽然我们认识到肠穿孔的风险仍在5 - 11%的范围内，但该研究的初步结果表明，贝伐单抗用于晚期卵巢癌的一线治疗可以安全给药。
