Grisham Rachel N, Iyer Gopa, Sala Evis, Zhou Qin, Iasonos Alexia, DeLair Deborah, Hyman David M, Aghajanian Carol
*Gynecologic Medical Oncology Service, Department of Medicine, †Human Oncology and Pathogenesis Program, ‡Department of Radiology, §Department of Epidemiology and Biostatistics, and ∥Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY.
Int J Gynecol Cancer. 2014 Jul;24(6):1010-4. doi: 10.1097/IGC.0000000000000190.
Low-grade serous (LGS) ovarian and primary peritoneal cancer is a rare disease with limited therapeutic options. Low response rates are observed with cytotoxic chemotherapy. However, significant responses have been reported in patients treated with bevacizumab. The objective of this study was to determine the response rate to bevacizumab with or without concurrent chemotherapy in patients with recurrent serous borderline or LGS ovarian or primary peritoneal cancer.
This single-institution retrospective study examined the response rate to treatment with bevacizumab in patients with serous borderline or LGS cancer. Patients were treated at the Memorial Sloan Kettering Cancer Center between 2005 and 2012. The best overall response was determined with the use of the Response Evaluation Criteria in Solid Tumors.
A total of 17 patients were identified, 15 of whom were evaluable for the primary end point of best overall response. Two patients were treated with bevacizumab as a single agent, and the remainder received bevacizumab in conjunction with chemotherapy (paclitaxel, topotecan, oral cyclophosphamide, gemcitabine, or gemcitabine and carboplatin). The median duration of bevacizumab administration in evaluable patients was 23 weeks (mean, 32.2 weeks; range, 6-79.4 weeks). There were no complete responses. Partial responses were observed in 6 patients (5 patients received concurrent paclitaxel, and 1 patient received concurrent gemcitabine). The overall response rate was 40%, with a response rate of 55% among the subgroup of patients with LGS cancer.
These results indicate that bevacizumab in combination with chemotherapy is an active treatment for recurrent LGS ovarian cancer. A prospective trial of bevacizumab in combination with paclitaxel for the treatment of LGS ovarian cancer should be considered.
低度恶性浆液性（LGS）卵巢癌和原发性腹膜癌是一种罕见疾病，治疗选择有限。细胞毒性化疗的缓解率较低。然而，有报道称接受贝伐单抗治疗的患者有显著缓解。本研究的目的是确定复发的浆液性交界性或LGS卵巢癌或原发性腹膜癌患者接受贝伐单抗治疗（无论是否联合化疗）的缓解率。
这项单机构回顾性研究考察了浆液性交界性或LGS癌症患者接受贝伐单抗治疗的缓解率。患者于2005年至2012年在纪念斯隆凯特琳癌症中心接受治疗。采用实体瘤疗效评价标准确定最佳总体缓解情况。
共确定17例患者，其中15例可评估最佳总体缓解这一主要终点。2例患者接受贝伐单抗单药治疗，其余患者接受贝伐单抗联合化疗（紫杉醇、拓扑替康、口服环磷酰胺、吉西他滨或吉西他滨与卡铂联合）。可评估患者中贝伐单抗给药的中位持续时间为23周（平均32.2周；范围6 - 79.4周）。无完全缓解。6例患者出现部分缓解（5例患者联合使用紫杉醇，1例患者联合使用吉西他滨）。总体缓解率为40%，LGS癌症患者亚组的缓解率为55%。
这些结果表明，贝伐单抗联合化疗是复发性LGS卵巢癌的一种有效治疗方法。应考虑开展贝伐单抗联合紫杉醇治疗LGS卵巢癌的前瞻性试验。
