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Weekly Administration of Bevacizumab, Gemcitabine, and Oxaliplatin in Patients With Recurrent and Refractory Ovarian Cancer: A Preliminary Result of 19 Cases
  1. Yuji Ikeda, MD*,,,
  2. Masashi Takano, MD, PhD*,§,
  3. Katsutoshi Oda, MD, PhD,
  4. Hiroko Kouta, PharmD*,
  5. Tomoko Goto, MD, PhD§,
  6. Kazuya Kudoh, MD, PhD*,,
  7. Naoki Sasaki, MD, PhD*,§,
  8. Tsunekazu Kita, MD, PhD*, and
  9. Yoshihiro Kikuchi, MD, PhD*
  1. *Department of Obstetrics and Gynecology, Ohki Memorial Kikuchi Cancer Center for Women, Saitama;
  2. Department of Obstetrics andGynecology, The University of Tokyo;
  3. Department of Obstetrics and Gynecology, Kawakita General Hospital, Tokyo;
  4. §DepartmentofObstetrics and Gynecology, National Defense Medical College;
  5. Department of Obstetrics and Gynecology, Nishisaitama-Chuo National Hospital, Tokorozawa, Saitama; and
  6. Department of Obstetrics and Gynecology, Nara Prefectural Nara Hospital, Nara, Nara, Japan.
  1. Address correspondence and reprint requests to Masashi Takano, MD, PhD, Department of Obstetrics and Gynecology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan. E-mail: mastkn@ndmc.ac.jp.

Abstract

Objective Combination therapy using gemcitabine with oxaliplatin (GEMOX) showed moderate activity in recurrent ovarian cancers. However, severe toxicities have been observed in patients who received full-dose therapy of GEMOX. On the other hand, bevacizumab enhances chemotherapeutic efficacy in various cancers. Here, we evaluated the effect of weekly low-dose administration of GEMOX in combination with bevacizumab (B-GEMOX) for patients with recurrent and refractory ovarian cancers (ROCs).

Methods A total of 19 patients with ROC were treated with B-GEMOX: 2 mg/kg of bevacizumab, 300 mg/m2 of gemcitabine, and 30 mg/m2 of oxaliplatin, 3 weeks on and 1 week off, q4weeks. The treatment was continued until development of severe toxicities or progressive disease. Tumor responses were assessed using the Response Evaluation Criteria in Solid Tumors and Gynecologic Cancer Intergroup criteria.

Results Median number of the B-GEMOX therapy was 5 cycles. Response was observed in 4 (34%) cases by Response Evaluation Criteria in Solid Tumors, and in 2 (29%) cases by Gynecologic Cancer Intergroup criteria, resulting in overall response rate of 32%. Clinical benefit excluding progressive disease was obtained in 79% of the patients. Median progression-free survival was 4.5 months (range, 2–16+ months). Toxicities were mild and mainly consisted of hematologic, gastrointestinal, and neuropathy; however, there were no nonhematologic toxicities more than grade 1.

Conclusions Weekly administration of B-GEMOX was active for patients with ROC and showed mild toxicities. These results warrant further prospective studies for patients with ROC.

  • Recurrent ovarian cancer
  • Platinum resistant
  • Bevacizumab
  • Gemcitabine
  • Oxaliplatin

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Footnotes

  • Presented as a poster presentation at the 48th Annual Meeting of the American Society of Clinical Oncology, Chicago, IL, June 1–5, 2012.

  • The authors declare no conflicts of interest.

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