初始接受贝伐单抗治疗的复发性卵巢癌患者的无铂间期及后续含铂化疗疗效评估：SGSG018/国际协作组研究

Evaluation of platinum-free interval and chemotherapeutic effect of subsequent platinum-containing chemotherapy in patients with recurrent ovarian cancer initially treated with bevacizumab: SGSG018/Intergroup study.

作者信息

Tanaka Tamaki, Takehara Kazuhiro, Usami Tomoka, Ishikawa Masako, Kondo Eiji, Kagabu Masahiro, Hirabayashi Kei, Matsumura Noriomi, Sato Shinya, Nishimura Masato, Arakawa Atsushi, Nakamura Keiichiro, Konno Yosuke, Fujiwara Satoe, Sueoka Kotaro, Nakamura Hiroko, Koh Iemasa, Ito Kimihiko, Hongo Atsushi

机构信息

Department of Perinatology and Gynecology, Kagawa University Graduate School of Medicine, Kagawa, Japan.

Department of Gynecologic Oncology, NHO Shikoku Cancer Center, Ehime, Japan.

出版信息

Gynecol Oncol Rep. 2025 Apr 9;59:101740. doi: 10.1016/j.gore.2025.101740. eCollection 2025 Jun.

DOI:10.1016/j.gore.2025.101740

PMID:40297564

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12036064/

Abstract

OBJECTIVE

The effect of bevacizumab on platinum sensitivity in recurrent ovarian cancer remains poorly understood. This study examined the association between platinum-free interval (PFI) and sensitivity to subsequent platinum-containing chemotherapy in patients with first relapsed ovarian cancer after bevacizumab chemotherapy.

METHODS

We retrospectively analyzed patients who received platinum-based chemotherapy for platinum-sensitive recurrence between November 2013, and December 2019, and who were initially treated by platinum-based chemotherapy with concurrent and maintenance bevacizumab. The primary endpoint was response rate to subsequent chemotherapy after various periods of PFI. The relevance between response rate and PFI was assessed for each PFI of 6-12, 12-24 and ≧24 months using Cochran-Armitage test. The secondary endpoint was progression-free survival (PFS) defined as time from chemotherapy for first recurrence to subsequent progression and response rate to subsequent chemotherapy for each treatment-free interval since last administration of bevacizumab (Bev-TFI).

RESULTS

A total of 77 patients were eligible. The median PFI until first recurrence was 12 months (range: 6-43). The response rates of subsequent chemotherapy for patients with PFI of 6-12, ≥12-24, and 24 months were 42 %, 65 %, and 80 %, showing a linear trend ( < 0.05). Median PFS among the three groups was 8 (95 %CI: 6.7-9.2), 11 (95 %CI: 8.4-13.5) and 13 months (95 % CI: 5.4-20.5) ( = 0.107, log-rank test), respectively. By contrast, no linear trend was observed between Bev-TFI and response rate ( = 0.225).

CONCLUSION

In patients with first relapse of primary ovarian cancer and bevacizumab beyond progression, the prolonged PFS effect of bevacizumab does not seem to affect sensitivity to subsequent platinum-based chemotherapy.

摘要

目的

贝伐单抗对复发性卵巢癌铂敏感性的影响仍知之甚少。本研究探讨了铂类无进展生存期（PFI）与首次复发的卵巢癌患者在接受贝伐单抗化疗后对后续含铂化疗的敏感性之间的关联。

方法

我们回顾性分析了2013年11月至2019年12月期间因铂敏感复发而接受铂类化疗，且最初接受铂类化疗联合并维持使用贝伐单抗治疗的患者。主要终点是不同PFI时间段后对后续化疗的反应率。使用 Cochr an - Armitage检验评估6 - 12个月、12 - 24个月和≥24个月各PFI时反应率与PFI之间的相关性。次要终点是无进展生存期（PFS），定义为从首次复发化疗到后续进展的时间，以及自最后一次使用贝伐单抗（Bev - TFI）以来每个无治疗间隔期对后续化疗的反应率。

结果

共有77例患者符合条件。至首次复发的中位PFI为12个月（范围：6 - 43个月）。PFI为6 - 12个月、≥12 - 24个月和24个月的患者后续化疗的反应率分别为42%、65%和80%，呈线性趋势（P < 0.05）。三组的中位PFS分别为8个月（95%CI：6.7 - 9.2）、11个月（95%CI：8.4 - 13.5）和13个月（95%CI：5.4 - 20.5）（P = 0.107，对数秩检验）。相比之下，未观察到Bev - TFI与反应率之间的线性趋势（P = 0.225）。