Bevacizumab in combination with sequential high-dose chemotherapy in solid cancer, a feasibility study

Area of Science:

• Oncology
• Pharmacology

Background:

• Sarcoma and germ cell cancer (GCC) can become refractory to standard chemotherapy.
• High-dose ifosfamide, carboplatin, and etoposide (HD-ICE) is a treatment regimen used for these cancers.
• Bevacizumab is a targeted therapy that inhibits vascular endothelial growth factor (VEGF).

Purpose of the Study:

• To evaluate the feasibility and toxicity of bevacizumab in combination with HD-ICE.
• To assess the efficacy of this combination in patients with refractory sarcoma and GCC.
• To explore the potential of bevacizumab in overcoming chemotherapy resistance.

Main Methods:

• Sixteen patients (13 sarcoma, 3 GCC) received standard-dose ICE followed by 4 cycles of HD-ICE with stem cell support and bevacizumab.
• Patients were evaluated for toxicity and efficacy.
• Treatment cycles were administered every 22 days.

Main Results:

• The combination was feasible in heavily pretreated patients, with a median of 3.3 cycles administered.
• No new unexpected toxicities were observed, except for a relatively high incidence of ifosfamide encephalopathy.
• One almost complete response in GCC and partial responses in 6 patients (4 sarcoma, 2 GCC) were observed.
• Median progression-free survival (PFS) and overall survival (OS) for sarcoma patients were 5 and 13 months, respectively.

Conclusions:

• Bevacizumab in combination with HD-ICE is a feasible treatment for refractory sarcoma and GCC.
• The combination shows potential efficacy, possibly by reversing chemotherapy resistance.
• Further investigation is warranted to confirm these findings and optimize treatment strategies.