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Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-59269

Achtari, C; Fink, D; Günthert, A R; Huober, J; Pestalozzi, B; Petignat, P; von Moos, R; Sessa, C (2011). Bevacizumab in the primary treatment of epithelial ovarian cancer – some comments on the latest results. Schweizer Krebs-Bulletin = Bulletin Suisse du Cancer, 35(1):35-38.

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Abstract

Adding the angiogenesis inhibitor bevacizumab to initial standard chemotherapy followed by bevacizumab alone as maintenance therapy prolongs progression-free survival (PFS) time significantly but modestly in women with advanced epithelial ovarian cancer. This finding has been reported consistently by two phase III trials, GOG-218 and ICON 7. At present, overall survival (OS) data are immature. Therefore, no recommendation can be made yet how to best incorporate bevacizumab in the front-line treatment of advanced ovarian cancer. Members of the gynecological cancer working group of the Swiss Group for Clinical Cancer Research (SAKK) and other specialists have discussed the latest findings with bevacizumab in ovarian cancer and their consequences for clinical practice. Ovarian cancer is the seventh most frequent cancer in women worldwide (1). Its incidence rates are highest in the western world, where it is the leading cause of death from gynecological malignancies (2, 3). Patients with stage III and IV ovarian cancer require a combined approach of surgery and chemotherapy. Primary debulking surgery plays a key role and the final outcome is highly dependent on the results achieved with the initial surgery: a residual tumor of >1 cm was found to be associated with a median overall survival of 12–16 months, while a longer median overall survival has been reported in patients with no macroscopic residual disease (4). The ultimate goal of surgery is cytoreduction to microscopic disease, the term optimal cytoreduction being reserved for those cases with no macroscopic residual disease. The standard first-line chemotherapy for advanced ovarian cancer usually contains a taxane and a platinum agent for six cycles (5-8). The response rate for this treatment is approximately 75%. However, 65% of these patients will develop tumor progression in the first three years after diagnosis. Over the past ten years, the only improvement in overall survival has been reported with the introduction of a dose dense schedule of paclitaxel (9) or by the use of local ip treatment in selected patients (10); the addition of a third cytotoxic to standard chemotherapy has not showed any significant advantage over the established first-line chemotherapy (11, 12).

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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Gynecology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2011
Deposited On:16 Feb 2012 14:19
Last Modified:20 Oct 2013 10:22
Publisher:SIAK/SAKK
Free access at:Related URL. An embargo period may apply.
Related URLs:http://sakk.ch/en/download/179

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