Asmane Irène, Kurtz Jean-Emmanuel, Bajard Agathe, Guastalla Jean-Paul, Meeus Pierre, Tredan Olivier, Labidi Galy Intidhar, Moullet Isabelle, Ardisson Philippe, Vincent Lionel, Coeffic David, Dufresne Armelle, Bergerat Jean-Pierre, Ray-Coquard Isabelle
CHU Hautepierre, Department of Oncology & Hematology, Strasbourg, France.
Bull Cancer. 2011 Oct;98(9):80-9. doi: 10.1684/bdc.2011.1436.
OBJECTIVES. As vascular endothelial growth factor (VEGF) is expressed in ovarian cancer, we assessed the efficacy and safety of bevacizumab (a monoclonal antibody targeting VEGF) plus microtubule targeting agents for heavily pre-treated ovarian carcinoma patients. METHODS. We retrospectively reviewed 43 patients with recurrent epithelial ovarian carcinoma. Combined treatment included bevacizumab with paclitaxel in 32 (74%), docetaxel in 10 (23%), and vinorelbine in one (2.3%) patients, respectively. RESULTS. The median number of combined treatment was six cycles (range 1-29). On RECIST criteria, the objective response rate (ORR) was 40% (16% CR and 24% PR). Clinical benefit (complete response [CR] plus partial response [PR] and stable disease [SD] lasting ≥ 3 months) was 74% (CI95%: 46.7-77%). Median duration of treatment and overall survival were 3.9 months (range 0.2-14.4 months) and 20.1 months (CI95%: 13.8-20.1) respectively. No toxic death was reported. Grade 3-4 toxicity occurred in 30% of patients. Gastrointestinal perforations and fistula occurred in 3 (7%) and 6 (14%) patients, respectively. CONCLUSION. Although being active in terms of ORR, bevacizumab plus microtubule targeting agents - mainly taxanes - leads to a high rate of gastro-intestinal perforations and fistula in heavily pre-treated ovarian carcinoma patients.
目的。由于血管内皮生长因子（VEGF）在卵巢癌中表达，我们评估了贝伐单抗（一种靶向VEGF的单克隆抗体）联合微管靶向药物用于接受过大量前期治疗的卵巢癌患者的疗效和安全性。方法。我们回顾性分析了43例复发性上皮性卵巢癌患者。联合治疗分别包括32例（74%）患者使用贝伐单抗联合紫杉醇、10例（23%）患者使用多西他赛以及1例（2.3%）患者使用长春瑞滨。结果。联合治疗的中位周期数为6个周期（范围1 - 29个周期）。根据RECIST标准，客观缓解率（ORR）为40%（完全缓解[CR]为16%，部分缓解[PR]为24%）。临床获益（完全缓解[CR]加部分缓解[PR]以及疾病稳定[SD]持续≥3个月）为74%（95%CI：46.7 - 77%）。治疗的中位持续时间和总生存期分别为3.9个月（范围0.2 - 14.4个月）和20.1个月（95%CI：13.8 - 20.1）。未报告有因毒性导致的死亡。3 - 4级毒性发生在30%的患者中。分别有3例（7%）和6例（14%）患者发生胃肠道穿孔和瘘管。结论。尽管贝伐单抗联合微管靶向药物（主要是紫杉烷类）在ORR方面有活性，但在接受过大量前期治疗的卵巢癌患者中会导致较高的胃肠道穿孔和瘘管发生率。
