Bevacizumab and advanced-stage ovarian cancer. Yet another oncological indication, but still best to avoid using this...

Epithelial ovarian, fallopian tube and primary peritoneal malignancies are treated in much the same way. Treatment for women with advanced-stage disease consists of surgical resection followed by platinum-based chemotherapy. Bevacizumab, a monoclonal antibody that targets vascular endothelial growth factor, is authorised in the European Union for the treatment of various malignancies. It was approved for first-line treatment of advanced-stage epithelial ovarian cancer, in combination with chemotherapy consisting of carboplatin + paclitaxel. Two trials involving a total of about 3400 women have evaluated the addition of bevacizumab in women receiving carboplatin + paclitaxel chemotherapy. In mid-2012, no statistically significant impact on median overall survival had emerged. Median "progression-free" survival was significantly prolonged when bevacizumab was added both during and after chemotherapy, by 4.1 months with 15 mg/kg and 2.4 months with 7.5 mg/kg. In one trial, "progression" was defined using laboratory or radiological parameters, but not necessarily clinical events. There was no statistically significant increase in "progression-free" survival when bevacizumab was only given during chemotherapy. continue treatment for adverse events, and also more likely to experience serious, sometimes fatal, adverse effects. The most frequent adverse effects of bevacizumab included haemorrhage, arterial hypertension, and gastrointestinal perforation. In practice, following surgery for advanced-stage epithelial ovarian cancer, it is best not to add bevacizumab to first-line chemotherapy.