When bevacizumab was added to standard chemotherapy, the patients with a poor prognosis of ovarian cancer had an overall survival benefit, according to the ICON7 study published online this week in journal The Lancet Oncology.

An international, phase 3, two-arm, open-label study included 1,528 women with newly diagnosed ovarian cancer, high-risk early-stage disease or more advanced disease, and an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2. The patients were randomly assigned to arm A with standard chemotherapy (carboplatin and paclitaxel) and arm B with standard chemotherapy plus bevacizumab.

The primary endpoint was progression-free survival (PFS), and the secondary endpoint was restricted mean survival time (RMST). 


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After a median follow-up of 48.9 months, there was no difference in PFS between the treatment arms. Moreover, RMST was no different in the overall study population with 44.6 months (95% CI: 43.2, 45.9) in arm A and 45.5 months (95% CI: 44.2, 46.7) in arm B (P=0.85). The patients in non-high-risk group had a similar outcome with no difference in RMST with 49.7 months (95% CI: 48.3, 51.1) in arm A and 48.4 months (95% CI: 47.0, 49.9) in arm B (P=0.20).

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However, in patients with poor prognosis disease, a significant difference in RMST was found where arm A had 34.5 months (95% CI: 32.0, 37.0) and arm B had 39.9 months (95% CI: 37.0, 41.7) (P=0.03).

The findings suggest that standard chemotherapy with bevacizumab shows benefit in patients with poor prognosis disease although no improvement in the overall study population.

Reference

  1. Oza AM, Cook AD, Pfisterer J, et al. Standard chemotherapy with or without bevacizumab for women with newly diagnosed ovarian cancer (ICON7): overall survival results of a phase 3 randomised trial. Lancet Oncol. 2015. [epub ahead of print]. doi: 10.1016/S1470-2045(15)00086-8.