ArticleEcancermedicalscience2025
Bevacizumab in recurrent epithelial ovarian cancer: real-world experience from a tertiary cancer hospital in India.
Article in Ecancermedicalscience, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: In combination with chemotherapy, bevacizumab, a humanised monoclonal antibody against angiogenesis, significantly increases progression-free survival (PFS) in recurrent epithelial ovarian cancer (EOC). However, due to financial constraints, real-world experience with bevacizumab in EOC is lacking in Indian populations. This study assessed bevacizumab's efficacy with chemotherapy in platinum-sensitive and resistant EOC in resource-limited Indian populations. Method and materials: This retrospective study was conducted at a regional cancer hospital in eastern India. Platinum-sensitive and resistant recurrent EOC patients were enrolled between 2021 and 2024. Patients' demographic and treatment details were retrieved from hospital medical records. All patients received bevacizumab 7.5 mg/kg IV dose with chemotherapy followed by maintenance till disease progression or inadvertent toxicity occurred. Primary endpoints were PFS and objective response rate (ORR); secondary endpoints were overall survival (OS) and safety. Kaplan-Meier plot generated PFS and OS survival curves. Results: 48 patients were enrolled. With a median follow-up of 37 months, 46% of patients progressed on bevacizumab. The median duration of PFS was 17 months (95% CI, 14.31-19.68); it was slightly higher in platinum-sensitive patients at 18 months (95% CI, 14.25-21.74). Half of the patients achieved partial response, with an ORR of 66%. Median OS was not reached due to fewer events. The 3-year OS rate was 83%. About 15 patients who progressed on bevacizumab were able to receive further chemotherapy lines. No new safety concerns were noted. Only 4.2% of patients developed grade 3 proteinuria, one developed arterial thrombosis and two had grade 3 thrombocytopenia. Only one patient died due to a GI fistula. Conclusion: Bevacizumab plus chemotherapy followed by bevacizumab maintenance till disease progression significantly improved PFS in recurrent EOC. This real-world finding suggests a crucial insight into effective treatment options for financially compromised Indian populations with recurrent EOC.
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