Bevacizumab in Platinum-Resistant Ovarian Cancer

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Patients with ovarian cancer who have progressed after first-line platinum-based chemotherapy after less than 6 months of treatment are considered as having platinum-resistant disease, states Robert L. Coleman, MD. Individuals who progress after 12 months have platinum-sensitive disease, and individuals who progress between 6 and 12 months fall into a gray zone of pseudosensitive disease.

Bevacizumab is an antiangiogenic agent that was approved in 2014 for the treatment of women with platinum-resistant, recurrent ovarian cancer. The approval was based the phase III AURELIA trial that randomized individuals to receive physician’s choice of chemotherapy or chemotherapy with bevacizumab, says Coleman. While progression-free survival nearly doubled with bevacizumab, there was no measurable change in overall survival. Many patients who were symptomatic saw resolution of their symptoms in a significant way, notes Coleman.

Improvement of symptoms, coupled with the limited number of options for this population of patients, shows that bevacizumab provides value in this setting. Although some efficacy differences existed between the various chemotherapy arms, the decision as to which specific agent to use with bevacizumab is often individualized for the patient and based upon physician preference.