Department of Medical Oncology, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain.
Translational Oncology Research Laboratory, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain.
Clin Transl Oncol. 2021 Mar;23(3):536-542. doi: 10.1007/s12094-020-02446-z. Epub 2020 Jul 10.
Treatment of recurrent ovarian carcinoma is a challenge, particularly for the clear cell (CCC) subtype. However, there is a preclinical rationale that these patients could achieve a benefit from antiangiogenic therapy. To assess this hypothesis, we used the growth modulation index (GMI), which represents an intrapatient comparison of two successive progression-free survival (PFS).
We conducted a retrospective real-world study performed on 34 patients with recurrent ovarian cancer, treated with bevacizumab-containing regimens from January 2009 to December 2017. The primary endpoint was GMI. An established cut-off > 1.33 was defined as a sign of drug activity.
73.5% of patients had high-grade serous ovarian carcinoma (HGSOC), and 17.7% had CCC; 70.6% of patients received carboplatin/gemcitabine/bevacizumab, and 29.4% received weekly paclitaxel/bevacizumab. According to histological subtype, the overall response rate and median PFS were 52% and 14 months for HGSOC and 83.3% and 20 months for CCC, respectively. The overall population median GMI was 0.99; it was 0.95 and 2.36 for HGSOC and CCC, respectively. CCC subtype was significantly correlated with GMI > 1.33 (odds ratio 41.67; 95% confidence interval 3.6-486.94; p = .03).
Adding bevacizumab to chemotherapy in recurrent CCC is associated with a remarkable benefit in this cohort. The efficacy of antiangiogenic drugs in CCC warrants further prospective evaluation.
复发性卵巢癌的治疗具有挑战性，尤其是透明细胞（CCC）亚型。然而，有临床前理论依据表明，这些患者可能从抗血管生成治疗中获益。为了评估这一假设，我们使用了生长调节指数（GMI），它代表了两次无进展生存（PFS）的患者内比较。
我们进行了一项回顾性真实世界研究，纳入了 34 名接受贝伐珠单抗为基础的方案治疗的复发性卵巢癌患者，研究时间为 2009 年 1 月至 2017 年 12 月。主要终点是 GMI。定义 GMI>1.33 为药物活性的标志。
73.5%的患者为高级别浆液性卵巢癌（HGSOC），17.7%为 CCC；70.6%的患者接受卡铂/吉西他滨/贝伐珠单抗治疗，29.4%的患者接受紫杉醇/贝伐珠单抗周疗。根据组织学亚型，HGSOC 的总体缓解率和中位 PFS 分别为 52%和 14 个月，CCC 分别为 83.3%和 20 个月。总体人群的中位 GMI 为 0.99；HGSOC 和 CCC 的 GMI 分别为 0.95 和 2.36。CCC 亚型与 GMI>1.33显著相关（优势比 41.67；95%置信区间 3.6-486.94；p=0.03）。
在复发性 CCC 中，贝伐珠单抗联合化疗具有显著获益。抗血管生成药物在 CCC 中的疗效值得进一步前瞻性评估。
