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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EVascular Endothelial Growth Factor (VEGF) promotes ascites and effusions in ovarian cancer [Byrne AT et al. \u003Cem\u003EClin Cancer Res\u003C\/em\u003E 2003], and it is an independent adverse predictor of patient prognosis [Shen GH et al. \u003Cem\u003EBr J Cancer\u003C\/em\u003E 2000]. Bevacizumab, a humanized monoclonal antibody that targets VEGF, has shown single-agent activity in Phase 2 epithelial ovarian cancer trials [Burger RA et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E 2011]. This article provides an update on the data available from Phase 3 bevacizumab ovarian cancer trials.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EReproductive Cancers\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EVascular Endothelial Growth Factor (VEGF) promotes ascites and effusions in ovarian cancer [Byrne AT et al. \u003Cem\u003EClin Cancer Res\u003C\/em\u003E 2003], and it is an independent adverse predictor of patient prognosis [Shen GH et al. \u003Cem\u003EBr J Cancer\u003C\/em\u003E 2000]. Bevacizumab, a humanized monoclonal antibody that targets VEGF, has shown single-agent activity in Phase 2 epithelial ovarian cancer trials [Burger RA et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E 2011]. Elizabeth A. Eisenhauer, MD, Queen\u0027s University, Kingston, Ontario, Canada, provided an update on the data available from Phase 3 bevacizumab ovarian cancer trials.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EThe Carboplatin and Paclitaxel with or Without Bevacizumab in Treating Patients with Stage III or Stage IV Ovarian Epithelial, Primary Peritoneal Cancer, or Fallopian Tube Cancer [Gynecologic Oncology Group (GOG)-0218; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00262847\u0026amp;atom=%2Fspmdc%2F12%2F15%2F28.atom\u0022\u003ENCT00262847\u003C\/a\u003E] trial was the first reported randomized study of bevacizumab in ovarian cancer. Patients with newly diagnosed stage III or IV epithelial ovarian, primary peritoneal (PP), or fallopian tube (FT) cancer who had undergone debulking surgery were randomized to the placebo group, bevacizumab-initiation group, or bevacizumab-throughout group [Burger RA et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E 2011]. All patients received paclitaxel and carboplatin. Progression-free survival (PFS) improved by approximately 4 months in the bevacizumab throughout group with a hazard ratio (HR) of 0.717 compared with an HR of 0.908 in the control group (p\u0026lt;0.001).\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EIn addition to GOG-0218, six other Phase 3 trials have been undertaken to evaluate the addition of an angiogenesis inhibitor to chemotherapy in epithelial ovarian cancer. Three of these have presented initial results (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E). In the International Collaborative Ovarian Neoplasm 7 [ICON7; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00483782\u0026amp;atom=%2Fspmdc%2F12%2F15%2F28.atom\u0022\u003ENCT00483782\u003C\/a\u003E] trial, women with newly diagnosed epithelial ovarian, PP, or FT cancer were randomized to either chemotherapy alone or concurrent bevacizumab and chemotherapy followed by maintenance bevacizumab [Perren TJ et al. \u003Cem\u003EAnn Oncol\u003C\/em\u003E 2010]. While the dose of bevacizumab in this trial was half the dose used in the GOG-0218 trial, a significant improvement in PFS was observed.\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/14534\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/14534\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/14534\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-5\u0022 class=\u0022first-child\u0022\u003EPhase 3 Trials Evaluating the Addition of an Angiogenesis Inhibitor in Epithelial OVCA.\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-7\u0022\u003EIn the Ovarian Cancer Study Comparing Efficacy and Safety of Chemotherapy and Anti-Angiogenic Therapy in Platinum-Sensitive Recurrent Disease [OCEANS; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00434642\u0026amp;atom=%2Fspmdc%2F12%2F15%2F28.atom\u0022\u003ENCT00434642\u003C\/a\u003E] trial, patients with platinum-sensitive recurrent ovarian cancer who had not previously received chemotherapy were randomized to either bevacizumab with gemcitabine plus carboplatin, or gemcitabine and carboplatin alone [Aghajanian C et al. \u003Cem\u003EJ Clin Oncol\u003C\/em\u003E 2012]. Dr. Eisenhauer said that bevacizumab resulted in \u201ca striking PFS increase in this trial.\u201d\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EThe AURELIA [\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00976911\u0026amp;atom=%2Fspmdc%2F12%2F15%2F28.atom\u0022\u003ENCT00976911\u003C\/a\u003E] trial, included patients with platinum-resistant ovarian cancer who had received 2 or less prior cancer therapies [Poveda A et al. ESMO 2012. Abstract LBA26]. All patients received 1 of 3 chemotherapy options chosen by the investigator and were randomized to receive either bevacizumab plus chemotherapy or chemotherapy alone. To date, data from this trial have indicated a PFS advantage for bevacizumab regardless of which chemotherapy regimen was chosen.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EFor all four Phase 3 bevacizumab trials, toxicity was greater in the bevacizumab arms and the cost of bevacizumab is considerable compared with chemotherapy. In addition, although these trials showed an impact of treatment on PFS, no trial has shown significant overall survival data in the analyses performed to date; however, with this observation it must be noted that the overall survival data are not yet mature for any of these trials. The investigators also need to analyze available data to clarify whether delay in progression is associated with freedom from symptoms for patients with ovarian cancer.\u003C\/p\u003E\u003Cp id=\u0022p-10\u0022\u003EDr. Eisenhauer said that \u201cgreat progress in completion of Phase 3 trials of angiogenesis inhibitors has been made in ovarian cancer over the past 2 to 3 years,\u201d and these trials have shown clear evidence of a biological effect for bevacizumab through improvement in PFS; nonetheless, it will be the final overall survival data that will determine whether bevacizumab is truly paradigm changing for ovarian cancer management. She argued that validated selection biomarkers are urgently needed to identify patient subsets that are truly benefiting from angiogenesis inhibition\u2014this knowledge may reveal those who do experience survival gains and reduce unnecessary treatment of those who do not, improving both therapeutic index and cost-effectiveness. Many of the studies discussed in the presentation included tissue, blood, and other sample collections that may serve as valuable resources for addressing these questions.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2012 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/12\/15\/28.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzn89d\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzn89d\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}