Real-world study of adding bevacizumab to chemotherapy for ovarian,
tubal, and peritoneal cancer as front-line or relapse therapy (ROBOT):
an observational cohort study
Objective. This study aimed to determine the real-world, long-term
prognostic impact and adverse effects (AEs) of bevacizumab (BEV) in
Asian patients with ovarian/tubal/peritoneal cancers. Design
Hospital-based observational cohort study. Setting Tertiary medical
centre in Southern Taiwan. Population Women diagnosed with ovarian,
tubal, peritoneal cancer. Methods. We retrospectively reviewed the
medical records of consecutive patients on front-line chemotherapy with
or without BEV (Cohort 1) and those who relapsed following chemotherapy
and/or BEV (Cohort 2) between 2011 and 2018. Main outcome measures
Patient clinicopathological characteristics, BEV dosages, clinical
outcomes, survivals, and AEs were analysed. Hazard ratios for disease
progression and death were analysed using a Cox model. Results. Benefits
of BEV used throughout triweekly, in terms of improved progression-free
survival (PFS) and overall survival (OS), were observed at a dosage of
7.5–15 mg/kg/cycle among advanced-stage Cohort 1 patients. A
progression-free interval of <6 months was the strongest
predictor of disease progression and death in advanced-stage patients.
BEV throughout and optimal cytoreduction were independent predictors of
reduced disease progression. Histology was not a prognostic predictor.
BEV resulted in improved OS in Cohort 2 patients, especially in the
platinum-sensitive subgroup. Most patients had a front-line BEV dosage
<10 mg/kg per cycle with <10 treatment cycles. Low
rates and grades of BEV-related AEs were observed. Conclusions BEV used
throughout effectively extended PFS and OS in advanced-stage patients.
Patients with platinum-sensitive carcinoma, treated with BEV, had a
significant improvement in OS and extended PFS. Therefore, BEV can
safely be added to chemotherapy for ovarian/tubal/peritoneal cancers.