AURELIA: bevacizumab combined with chemotherapy for platinum-resistant recurrent ovarian cancer
Adding bevacizumab to single-agent chemotherapy for platinum-resistant ovarian cancer doubled the time to progression and more than doubled the response rate, without a significant gain in survival.
Overview
Open-label randomised phase 3 trial: 361 women with platinum-resistant recurrent ovarian cancer received the investigator's choice of weekly paclitaxel, pegylated liposomal doxorubicin or topotecan, alone or with bevacizumab.
Median progression-free survival was 6.7 months with bevacizumab against 3.4 months (hazard ratio 0.48, p < 0.001); response rate 27.3 against 11.8 percent; median overall survival 16.6 against 13.3 months (hazard ratio 0.85, p 0.174). Grade 2 or higher hypertension and proteinuria were more common with bevacizumab; gastrointestinal perforation occurred in 2.2 percent.
- Median progression-free survival 6.7 versus 3.4 months; hazard ratio 0.48 (95% CI 0.38 to 0.60), p < 0.001.
- Objective response 27.3 versus 11.8 percent (p 0.001).
- Median overall survival 16.6 versus 13.3 months; hazard ratio 0.85 (0.66 to 1.08), not significant.
Bevacizumab with weekly paclitaxel, liposomal doxorubicin or topotecan is a standard option in platinum-resistant ovarian cancer; approved in the United States in 2014.
- Open-label; patients with more than two prior regimens or bowel involvement at risk of perforation were excluded.
- Crossover to bevacizumab at progression diluted the survival comparison.
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