Bevacizumab in ovarian cancer: A critical review of phase III studies

// Luigi Rossi 1 , Monica Verrico 1 , Eleonora Zaccarelli 1 , Anselmo Papa 1 , Maria Colonna 2 , Martina Strudel 1 , Patrizia Vici 3 , Vincenzo Bianco 5 and Federica Tomao 4 1 Department of Medico-Surgical Sciences and Biotechnologies, “Sapienza” University of Rome, Oncology Unit, “ICOT,” Latina, Italy 2 Oncology Unit, Dono Svizzero Hospital, Formia, Italy 3 Division of Medical Oncology 2, “Regina Elena” National Cancer Institute, Rome, Italy 4 Department of Gynaecology and Obstetrics, “Sapienza” University of Rome, Policlinico “Umberto I”, Rome, Italy 5 Division of Medical Oncology A, “Sapienza” University of Rome, Policlinico “Umberto I”, Rome, Italy Correspondence to: Rossi Luigi, email: // Keywords : ovarian cancer, bevacizumab, biological therapy, anti-angiogenic therapy, chemotherapy Received : June 11, 2016 Accepted : October 13, 2016 Published : November 11, 2016 Abstract Bevacizumab (BV) is a humanized monoclonal antibody targeting vascular endothelial growth factor and it is the first molecular-targeted agent to be used for the treatment of ovarian cancer (OC). Randomized Phase III trials evaluated the combination of BV plus standard chemotherapy for first-line treatment of advanced OC and for platinum-sensitive and platinum-resistant recurrent OC. These trials reported a statistically significant improvement in progression-free survival but not in overall survival. Furthermore, BV effectively improved the quality of life with regard to abdominal symptoms in recurrent OC patients. Bevacizumab is associated with adverse events such as hypertension, bleeding, thromboembolism, proteinuria, delayed wound healing, and gastrointestinal events. However, most of these events can be adequately managed. This review describes the latest evidence for BV treatment of OC and selection of patients for personalized treatment.