Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2020 Apr;61(4):284-290. doi: 10.3349/ymj.2020.61.4.284.
We evaluated whether adding bevacizumab to current platinum-based chemotherapy could improve clinical outcomes without affecting safety.
We retrospectively reviewed medical records of patients with pathologically confirmed ovarian cancer who received neoadjuvant chemotherapy (NAC) at Yonsei Cancer Hospital. We divided the patients into groups based on the use of bevacizumab for NAC (CP group: carboplatin+paclitaxel vs. BCP group: bevacizumab+carboplatin+paclitaxel) and compared patient characteristics, responses to NAC, and surgical and survival outcomes between the two groups. Overall, 88 patients in the CP group and 16 patients in the BCP group received NAC. The primary endpoint was survival outcomes. Complete resection rate after interval debulking surgery (IDS), cancer antigen 125 (CA-125) normalization after NAC, and chemotherapy response score were secondary endpoints.
After NAC treatment, all patients underwent IDS. There were no significant differences in adverse events during NAC or postoperative complications between the two groups (=0.293 and =0.485, respectively). There were also no significant differences in CA-125 normalization after NAC (42.0% vs. 43.8%, =0.899) or complete resection rate after IDS (47.7% vs. 56.3%, =0.530). However, although the BCP group did not show longer overall survival (OS) (log-rank =0.854), they had significantly longer progression-free survival (PFS) than the CP group (log-rank =0.048).
Bevacizumab-containing NAC might be safe and provide longer PFS than chemotherapy alone in patients with advanced ovarian cancer. However, further study is necessary to investigate the impact of bevacizumab-containing NAC on OS.
我们评估了在当前铂类化疗基础上加入贝伐珠单抗是否能在不影响安全性的情况下改善临床结局。
我们回顾性分析了在延世癌症医院接受新辅助化疗（NAC）的病理证实卵巢癌患者的病历。我们根据 NAC 中贝伐珠单抗的使用情况将患者分为两组（CP 组：卡铂+紫杉醇 vs. BCP 组：贝伐珠单抗+卡铂+紫杉醇），比较两组患者的特征、NAC 反应以及手术和生存结局。共有 88 例 CP 组和 16 例 BCP 组患者接受了 NAC。主要终点为生存结局。间隔减瘤术（IDS）后完全切除率、NAC 后癌抗原 125（CA-125）正常化率和化疗反应评分是次要终点。
NAC 治疗后，所有患者均接受了 IDS。两组患者 NAC 期间的不良事件或术后并发症发生率无显著差异（=0.293 和=0.485）。NAC 后 CA-125 正常化率（42.0% vs. 43.8%，=0.899）或 IDS 后完全切除率（47.7% vs. 56.3%，=0.530）也无显著差异。然而，BCP 组虽然总生存（OS）无显著延长（对数秩=0.854），但无进展生存（PFS）显著长于 CP 组（对数秩=0.048）。
在晚期卵巢癌患者中，贝伐珠单抗联合 NAC 可能安全，且能比单纯化疗提供更长的 PFS。然而，需要进一步研究来探讨贝伐珠单抗联合 NAC 对 OS 的影响。
