Researchers from the Hoag Cancer Center and the Desert Regional Cancer Center in California have reported that an outpatient regimen of Taxol® (paclitaxel), Platinol® (carboplatin) and Avastin (bevacizumab) can safely be administered to patients with newly diagnosed ovarian cancer. The details of this study appeared in the July-August, 2007 issue of the International Journal of Gynecological Oncology.[1]
Avastin is a recombinant humanized monoclonal antibody to vascular endothelial growth factor (VEGF). VEGF appears to play an important role in tumor angiogenesis, and blocking this activity should have an anti-tumor effect. Clinical trials of Avastin have shown activity in a variety of tumors, especially when combined with other agents. Recent studies have suggested that Avastin is an effective drug for the treatment of recurrent ovarian cancer and that responses can be improved by adding cytotoxic chemotherapy. However, a recent study has shown that the addition of chemotherapy to Avastin increases toxicity significantly with a gastrointestinal perforation rate of 7%.[2]
The purpose of the current study was to determine the safety of adding Avastin to a standard regimen of Taxol and Platinol for the initial treatment of women with epithelial ovarian, peritoneal and fallopian tube cancer. Twenty patients were treated on this Phase II study. Grade 4 neutropenia occurred in 25% of patients and there was no grade 3-4 thrombocytopenia or anemia. Importantly, there were no gastrointestinal perforations as were observed in treating patients with recurrent disease. The complete response rate was 30% and the partial response rate was 50%. An additional patient had stable disease and one had disease progression. These authors suggest that Avastin can safely be added to up-front chemotherapy for advanced ovarian cancer.
Comments: This study shows that the addition of Avastin to Platinol and Taxol does not increase toxicity significantly in newly diagnosed patients with advanced ovarian cancer and that Phase III studies can be carried out to determine if Avastin improves effectiveness.
References:
[1] Micha JP, Goldwtein BH, Rettenmaier MA, et al. A Phase II study of outpatient first-line paclitaxel, carboplatin, and bevacizumab for advanced-stage epithelial ovarian, peritoneal and fallopian tube cancer. International Journal of Gynecological Oncology. 2007; 17:771-776.
[2]Wright JD, Secord AA, Numnum TM, et al. A multi-institutional evaluation of factors predictive of toxicity and efficacy of bevacizumab for recurrent ovarian cancer. International Journal of Gynecological Cancer.2007; early on-line publication on July 21, 2007.
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