Outcomes for Women Receiving Bevacizumab for Treatment of Ovarian Cancer Versus Other Solid Tumors at an Academic Oncology Center

Abstract

Background

The main objective of this study was to determine the incidence of severe toxicity associated with bevacizumab use in women with ovarian cancer compared with that in women with other solid tumors.

Patients and Methods

This retrospective cohort study was performed by evaluating women treated with single-agent or combination bevacizumab in the Program in Women's Oncology between January 2004 and May 2009. Data was collected from electronic and office-based medical records. Toxicity was assessed according to the National Cancer Institute's Common Toxicity Criteria version 3.0 guidelines. A total of 103 women were treated with bevacizumab: 41 women (40%) with ovarian cancer and 62 (60%) with other solid tumors.

Results

There was no increase in the number of toxic effects seen in patients treated for ovarian cancer versus other tumor types. However, GI perforations were seen in 7.3% of women with ovarian cancer, whereas none were seen in those treated for other cancers (P = .06). More than 1 bevacizumab-related toxic effect (hazard ratio [HR], 2.74; 95% CI, 1.35-5.55) and treatment with bevacizumab after 3 prior lines of chemotherapy (HR, 2.44; 95% CI, 1.159-5.129) were associated with an increase in mortality in women with ovarian cancer. We found no significant difference in the incidence of bevacizumab-related toxicities when comparing ovarian cancer to other cancers. However, ovarian cancer patients did appear to have a statistically nonsignificant higher percentage of GI perforations.

Conclusion

Further studies evaluating patient factors associated with increased risk of toxicities may be warranted to assist with appropriate patient selection prior to bevacizumab use.