Bevacizumab plus low-dose metronomic oral cyclophosphamide in heavily pretreated recurrent ovarian cancer.

Sánchez-Muñoz, Alfonso; Mendiola, C.; Rodríguez, Carlos Aníbal; Pérez‐Ruiz, Elisabeth; Jurado, José Miguel; Alonso-Carrión, Lorenzo; Ghanem, Ismael; Deelasco, G.; Blanco, C. Quero; Alba, E

doi:10.1200/jco.2010.28.15_suppl.e15507

Cited by 2 publications

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“…There were four episodes of gastrointestinal perforation or fistula, amongst other adverse events. A very similar study of bevacizumab and metronomic oral cyclophosphamide was conducted in 38 patients with heavily-pretreated, recurrent ovarian cancer (Sanchez-Munoz 2010). This trial found a median PFS of 4.5 months, and a median OS of 10.7 months; there were no cases of gastrointestinal perforation.…”

Section: Discussionmentioning

confidence: 99%

Angiogenesis inhibitors for the treatment of ovarian cancer

Gaitskell

Martinek

Bryant

et al. 2011

Cochrane Database of Systematic Reviews

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Background Many women with ovarian cancer eventually develop resistance to conventional chemotherapy drugs, and so novel agents are being developed to target specific molecular pathways. One such class of drugs inhibits angiogenesis (the development of new blood vessels), which is essential for tumour growth. It is important to establish whether the addition of these new drugs to conventional chemotherapy regimens improves survival, and what the side-effects may be. Objectives To compare the effectiveness and toxicities of angiogenesis inhibitors in the treatment of ovarian cancer. Search methods We sought to identify completed randomised controlled trials (RCTs) by searching The Cochrane Gynaecological Cancer Review Group’s Trial Register, The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 10), MEDLINE and EMBASE (1990 to October 2010). We also searched registers of clinical trials, and contacted investigators of completed and ongoing trials for further information. Selection criteria Randomised controlled studies comparing angiogenesis inhibitors with either standard chemotherapy or no treatment, in women with ovarian cancer. Data collection and analysis Two independent authors carried out data collection and extraction. We used a random-effects model for pooling data. Main results We did not find any fully-published, completed RCTs of angiogenesis inhibitors that met our inclusion criteria. We identified five abstracts of completed RCTs of four different angiogenesis-inhibiting agents, with a total of 3701 participants. Meta-analysis of two trials found no statistically significant difference in overall survival (OS) between women with newly-diagnosed advanced ovarian cancer who received concurrent and maintenance bevacizumab compared to those who received chemotherapy (carboplatin and paclitaxel) alone. However, women who received concurrent and maintenance bevacizumab had their risk of disease progression reduced by a quarter (hazard ratio (HR) 0.75, 95% confidence interval (CI) 0.68 to 0.83; P < 0.001); they also had a significantly increased risk of severe gastrointestinal adverse events, moderate or severe hypertension and severe bleeding. One trial also compared chemotherapy to concurrent (but not maintenance bevacizumab), and found no statistically significant difference in OS or progression-free survival (PFS). However, the women who received bevacizumab had a significantly higher risk of moderate or severe hypertension. A three-armed RCT, of paclitaxel alone or with low- or high-dose AMG 386, in women with recurrent ovarian cancer, found no statistically significant difference in OS. However, women who received low-dose AMG 386 had a third less risk of disease progression than those who received placebo (HR 0.57, 95% CI 0.36 to 0.91; P = 0.02). The trial found no evidence of increased adverse events in the intervention arms. Two relatively small RCTs (one of VEGF-Trap, the other of BIBF 1120) found no evidence of either significant survival benefi...

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Section: Discussionmentioning

confidence: 99%

Angiogenesis inhibitors for the treatment of ovarian cancer

Gaitskell

Martinek

Bryant

et al. 2011

Cochrane Database of Systematic Reviews

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“…Recent clinical trials have reported that bevacizumab prolongs progressionfree survival in EOC. [77][78][79][80] Bevacizumab itself can be conjugated to radioactive substances for application in PET. This was illustrated in a murine ovarian tumor xenograft model, in which bevacizumab conjugated to 111 In or 89 Zr showed clear tumor uptake on microPET.…”

Section: Vascular Endothelial Growth Factormentioning

confidence: 99%

“…Recent clinical trials have reported that bevacizumab prolongs progression-free survival in EOC. 77–80…”

Section: Tumor-specific Targets For Fluorescence Imagingmentioning

confidence: 99%

Intraoperative Imaging in Ovarian Cancer: Fact or Fiction?

et al. 2011

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Tumor-targeted fluorescence imaging for cancer diagnosis and treatment is an evolving field of research that is on the verge of clinical implementation. As each tumor has its unique biologic profile, selection of the most promising targets is essential. In this review, we focus on target finding in ovarian cancer, a disease in which fluorescence imaging may be of value in both adequate staging and in improving cytoreductive efforts, and as such may have a beneficial effect on prognosis. Thus far, tumor-targeted imaging for ovarian cancer has been applied only in animal models. For clinical implementation, the five most prominent targets were identified: folate receptor α, vascular endothelial growth factor, epidermal growth factor receptor, chemokine receptor 4, and matrix metalloproteinase. These targets were selected based on expression rates in ovarian cancer, availability of an antibody or substrate aimed at the target approved by the Food and Drug Administration, and the likelihood of translation to human use. The purpose of this review is to present requirements for intraoperative imaging and to discuss possible tumor-specific targets for ovarian cancer, prioritizing for targets with substrates ready for introduction into the clinic.

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Bevacizumab plus low-dose metronomic oral cyclophosphamide in heavily pretreated recurrent ovarian cancer.

Cited by 2 publications

References 0 publications

Angiogenesis inhibitors for the treatment of ovarian cancer

Angiogenesis inhibitors for the treatment of ovarian cancer

Intraoperative Imaging in Ovarian Cancer: Fact or Fiction?

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