Adding Bevacizumab to ADT May Be Effective for Recurrent Prostate Cancer
Adding bevacizumab to androgen deprivation therapy resulted in improved relapse-free survival in patients with hormone-sensitive prostate cancer.
Adding bevacizumab to androgen deprivation therapy (ADT) resulted in improved relapse-free survival in patients with hormone-sensitive prostate cancer, a study published in the Journal of Clinical Oncology has shown.1
ADT is a typical treatment strategy for patients with recurrent prostate cancer who have received local therapy. Researchers sought to investigate efficacy and toxicity of short-course ADT with or without bevacizumab, a vascular endothelial growth factor A (VEGF-A) inhibitor, in men with hormone-sensitive prostate cancer.
For the phase 2 study, researchers enrolled 102 patients who had an increasing prostate-specific antigen (PSA) of no more than 50 ng/mL and a PSA level that has doubled in less than 18 months. Patients were eligible if they had either no metastases or low burden, asymptomatic metastases.
Participants were randomly assigned 2:1 to receive bicalutamide as ADT plus bevacizumab or ADT alone for 6 months.
Results showed that patients receiving ADT plus bevacizumab had a relapse-free survival of 13.3 months compared with 10.2 months for ADT alone (HR, 0.47; 95% CI, 0.29 - 0.77; P = .002). Relapse was defined as a PSA of more than 0.2 ng/mL for prostatectomy patients or PSA of more than 2.0 ng/mL for primary radiation therapy patients.
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In terms of safety, 36% of patients who received ADT plus bevacizumab developed hypertension.
Although these findings are encouraging, long-term follow-up is necessary to determine whether some patients achieve a durable PSA response are able to discontinue ADT for prolonged periods.
- McKay RR, Zurita AJ, Werner L, et al. A randomized phase II trial of short-course androgen deprivation therapy with or without bevacizumab for patients with recurrent prostate cancer after definitive local therapy [published online ahead of print April 4, 2016]. J Clin Oncol. doi: 10.1200/JCO.2015.63.3154.