Phase II Study of Bevacizumab in Patients With Platinum-Resistant Ovarian Cancer or Peritoneal Serous Cancer

Cannistra, Stephen A.; Matulonis, Ursula A.; Penson, Richard T.; Hambleton, Julie; Dupont, Jakob; Mackey, Howard M.; Douglas, Jeffrey A.; Burger, Robert A.; Armstrong, Deborah K.; Wenham, Robert M.; McGuire, William P.

doi:10.1200/jco.2007.12.0782

Cited by 700 publications

(459 citation statements)

References 22 publications

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“…Given that the platinum-sensitive recurrent ovarian cancers responses to 2 nd line chemotherapy in 47.2-61.7% (Bolis et al, 2001;Cantu et al, 2002;Parmar et al, 2003;Pfisterer et al, 2006) and platinum-refractory responses in only 6.1-25.7% (ten Bokkel et al, 1997;Gordon et al, 2001;Rosenberg et al, 2002;Berkenblit et al, 2004Cannistra et al 2007Mutch et al, 2007), this group of patients treated at Burzynski's Clinic should response in 6.1-25.7%, similar to platinum-refractory cases. Surprisingly, they responded in 42.42%.…”

Section: Discussionmentioning

confidence: 95%

“…Markedly lower OR of 6.1-25.7% was reported with single agent chemotherapies: [topotecan (ten Bokkel et al, 1997), pegylated liposomal doxorubicin (Gordon et al, 2001), weekly paclitaxel (Rosenberg et al, 2002), docetaxel (Berkenblit et al, 2004), gemcitabine (Mutch et al, 2007), and bevacizumab (Cannistra et al. 2007)] for platinum resistant diseases .…”

Section: Introductionmentioning

confidence: 99%

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Personalized Cancer Treatment for Ovarian Cancer

Chumworathayi¹

2013

Asian Pacific Journal of Cancer Prevention

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Recently there have been numerous advances in understanding the genetic basis of cancer which have resulted in more appropriate treatments. In this paper we describe the experience of the Burzynski Clinic, involved in treatment of numerous patients based on personalized approach using novel combinations for difficult-to-treat malignancies, with gynecological cancers. This retrospective study was conducted by extracting data from Burzynski Clinic's medical records and comprehensive review. Among the advanced refractory ovarian cancers cases (N=33), an objective response (OR) was found in 42.4%. We anticipate that with improved technology and novel therapeutics this rate will increase and adverse events will be reduced.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Personalized Cancer Treatment for Ovarian Cancer

Chumworathayi¹

2013

Asian Pacific Journal of Cancer Prevention

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“…These changes are hypothesized to result in improved delivery of oxygen, nutrients, and cytotoxic chemotherapy to the tumor [43]. Table 1 details notable phase 2 studies of anti-angiogenesis therapy in EOC [44][45][46][47][48][49][50][51][52][53][54]. Of the 6 molecules studied, 5 have been advanced to the phase 3 arena.…”

Section: Phase 2 Studiesmentioning

confidence: 99%

Incorporation of anti-angiogenesis therapy in the management of advanced ovarian carcinoma—Mechanistics, review of phase III randomized clinical trials, and regulatory implications

Eskander

Tewari

2014

Gynecologic Oncology

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“…The initial enthusiasm generated was blunted, however, when an increased risk of gastrointestinal (GI) perforation was detected. In a study intended for registration, Cannistra et al [6] evaluated bev in platinum-resistant OC and noted a median progression-free survival (PFS) of 4.4 months. The study was halted because of an 11.4% incidence of GI perforation, and a black box warning from the FDA ensued.…”

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confidence: 99%

Breaking Down the Evidence for Bevacizumab in Ovarian Cancer

Shu

Konner

2015

The Oncologist

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In 1971, Judah Folkman prophesized thatantivascular therapies could be used to fight cancer [1]. Since the 1990s, vascular endothelial growth factor (VEGF) has been recognized as a critical element in tumor angiogenesis and as an adverse factor in ovarian cancer (OC) [2]. It has now been 10 years since the U.S. Food and Drug Administration (FDA) initially approved bevacizumab (bev), the anti-VEGF monoclonal antibody that became one of the top-selling cancer drugs in the world. Its approved indications include colorectal, lung, kidney, cervix, and (previously) breast cancers, and it has been used widely as a standard therapy for OC for more than 5 years. Bev is licensed by the European Medicines Agency for use in first-line, first platinum-sensitive recurrence, and platinum-resistant OC. Bev was recently FDA approved for use in combination with singleagent chemotherapy for platinum-resistant disease; however, its optimal role in this cancer remains unclear. SINGLE-AGENT ACTIVITYIn early phase II trials, bev yielded single-agent activity beyond that seen in colorectal or lung cancer [3,4]. The addition of oral daily "metronomic" cyclophosphamide appeared to increase responses even further [5]. The initial enthusiasm generated was blunted, however, when an increased risk of gastrointestinal (GI) perforation was detected. In a study intended for registration, Cannistra et al. [6] evaluated bev in platinum-resistant OC and noted a median progression-free survival (PFS) of 4.4 months. The study was halted because of an 11.4% incidence of GI perforation, and a black box warning from the FDA ensued. Meta-analyses confirmed an increased risk of perforation and treatment-related mortality in a variety of cancer types [7,8].Since then, efforts to identify predictors of adverse GI events have successfully aided patient selection in clinical practice. Some of the compelling red flags in ovarian cancer include high-volume peritoneal carcinomatosis enveloping the bowel and history of malignant bowel obstruction. For patients receiving front-line therapy, history of treatment for inflammatory bowel disease and bowel resection at primary surgery [9] appear to increase risk. Presently, the risk of GI perforation from bev in recurrent OC is likely closer to 3% rather than the 11% observed in the population treated by Cannistra et al. [6]. RECURRENT DISEASEOCEANS [10] was a randomized phase III trial testing the combination of gemcitabine and carboplatin with or without the addition of bev given concurrently and then as maintenance until progression in platinum-sensitive OC. PFS for the bev arm was 12.4 months (vs. 8.4 months; p , .001). By the final analysis, however, there was no difference in overall survival (OS; 33.6 vs. 32.9 months) [11]. Of note, nearly all of the women in both arms went on to receive additional therapy, including bev.In the AURELIA trial [12], bev was combined with the investigator's choice of single-agent chemotherapy (weekly paclitaxel, pegylated liposomal doxorubicin, topotecan), in platinum-resistant OC...

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Phase II Study of Bevacizumab in Patients With Platinum-Resistant Ovarian Cancer or Peritoneal Serous Cancer

Abstract: Bevacizumab has single-agent activity in patients with platinum-resistant EOC or PSC. A higher than expected incidence of GIP was noted in these heavily pretreated patients.

Cited by 700 publications

References 22 publications

Personalized Cancer Treatment for Ovarian Cancer

Personalized Cancer Treatment for Ovarian Cancer

Incorporation of anti-angiogenesis therapy in the management of advanced ovarian carcinoma—Mechanistics, review of phase III randomized clinical trials, and regulatory implications

Breaking Down the Evidence for Bevacizumab in Ovarian Cancer

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