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Expert Discusses Benefits, Next Steps With Bevacizumab in Recurrent Ovarian Cancer

Gina Columbus @ginacolumbusonc
Published: Wednesday, Apr 12, 2017

Dana Chase, MD

Dana Chase, MD

Three pivotal clinical trials have shown the significance of the angiogenesis inhibitor bevacizumab (Avastin) as treatment for patients with recurrent ovarian cancer. However, asks Dana Chase, MD, what else can be accomplished with this agent to provide a greater benefit to patients?

State of the Science Summit on Advanced Ovarian Cancer, Chase, an associate professor at Creighton University, University of Arizona College of Medicine, and gynecologist oncologist with Arizona Oncology, lectured on the use of bevacizumab in patients with recurrent disease. In an interview, she expanded on the pivotal clinical trials, managing toxicities with these regimens, and the questions researchers still need to answer regarding bevacizumab.

OncLive: Can you give an overview of your presentation on chemotherapy and bevacizumab regimens in ovarian cancer?

Chase: Talking about recurrent ovarian cancer is one of the most challenging parts of being a gynecologic oncologist. These women had treatment before, they have had surgery, and now they’re suffering a recurrence. The approach to treatment for them can be very difficult. You are not only trying to manage a tumor that’s not resectable, but you’re also trying to manage toxicities. These women, at this point, know that they are not going to be cured. They have things they want to do in their life, and they don’t want to feel too sick. They are sick of feeling sick. You have to really manage disease control with toxicity, which is really important to consider in this patient population.

GOG-0213 and OCEANS are both studies that led to the approval of bevacizumab in recurrent platinum-sensitive ovarian cancer. GOG-0213 used carboplatin with paclitaxel and bevacizumab, and the OCEANS study used carboplatin with gemcitabine and bevacizumab. GOG-0213 had an impressive improvement in OS and the OCEANS study had an improvement in PFS. Therefore, we are now allowed to treat platinum-sensitive patients with chemotherapy plus bevacizumab followed by bevacizumab maintenance. Again, the toxicity of bevacizumab maintenance is very easy to address in these patients; they are essentially able to get back to their normal lives. 

Honing in on the toxicity profiles of some of these regimens, what advice do you have for managing side effects?

That is one of the most challenging parts of my job—managing these side effects. For example, with paclitaxel—one of the most commonly used drugs for ovarian cancer—I always tell my patients that the number 1 side effect that patients complain about is hair loss. Paclitaxel causes alopecia.
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