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Ovarian Cancer
A Real-Life Experience of Bevacizumab in Elderly Women With Advanced Ovarian Carcinoma
  1. Guillaume Beinse, MD*,
  2. George Emile, MD*,
  3. Anatole Cessot, MD*,
  4. Pascaline Boudou-Rouquette, MD*,
  5. Olivier Huillard, MD*,
  6. Nathaniel E.B. Saidu, PhD*,
  7. Bruno Borghese, MD, PhD†,
  8. François Goldwasser, MD, PhD*,
  9. Eric Pujade Lauraine, MD, PhD‡ and
  10. Jérôme Alexandre, MD, PhD*
  1. *Departments of Medical Oncology and
  2. †Departments of Gynecology Oncology, Cochin-Port Royal Hospital, Sorbonne Paris-CitéDepartments of University, Cancer Personalized Medicine, Assistance Publique-HôDepartments of pitaux de Paris; and
  3. ‡Departments of Women Cancer Clinical Research Unit, Hotel Dieu, Paris, France.
  1. Address correspondence and reprint requests to Jérôme Alexandre, MD, PhD, Department of Medical Oncology, Cochin Port-Royal Hospital, 123 Boulevard de Port Royal, 75014 Paris, France. E-mail: jerome.alexandre@aphp.fr.

Abstract

Objective This study aimed to assess the tolerance of bevacizumab (BEVA) among older ovarian cancer patients in daily clinical practice and identify a subpopulation of patients with a high risk of severe adverse effects.

Methods Consecutive patients with a pathologically proven high-grade serous ovarian, tubal, or peritoneal carcinoma who received BEVA between January 2006 and June 2014 were included in a retrospective analysis.

Results Among 86 BEVA-treated patients, 42 (48.8%) received concomitant chemotherapy, 26 (30%) had baseline arterial hypertension (HTN), and 33 (38.4%) were considered elderly (>70 years). Incidence of arterial, venous thromboembolism, hemorrhage, and bowel perforation were 2%, 8%, 12%, and 0%, respectively, and was not related to age. Incidence of severe (NCI-CTC v4 G3–4) HTN was significantly higher in elderly patients than in younger ones (39%; 95% confidence interval [CI], 22%–56% vs 17%; 95% CI, 7%–27%) (P = 0.017 by χ2 test) and in patients with baseline HTN (P < 0.05). Twenty-three percent of younger patients had baseline HTN compared with 42% of older ones (P = 0.052). Among patients without baseline HTN, older age was not associated with increased risk of severe HTN. However, incidence of severe HTN reached 71% (95% CI, 47%–95%) in older patients with baseline HTN. Exploratory analysis indicates that progression-free survival was similar in younger and older patients.

Conclusions Bevacizumab is feasible in patients older than 70 years with advanced ovarian carcinoma. More attention must be paid to elderly patients with baseline HTN.

  • Ovarian carcinoma
  • Bevacizumab
  • Elderly patients
  • Arterial adverse effect

https://doi.org/10.1097/IGC.0000000000000833

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    Footnotes

    • N.S. is supported by the CARPEM program.

    • G.B. reports support for travel to meetings for the study or other purposes from Novartis and from Roche outside the submitted work. G.E. reports, outside the submitted work, board membership with Roche; expert testimony with Sanofi-Aventis France, Merck Serono, and Amgen SAS; and travel/accommodations/meeting expenses with Hospira. P.B-R. reports consulting with Roche outside the submitted work. O.H. reports consultancy with Bayer; payment for lectures including service on speakers’ bureaus with Astellas, MSD, Bayer, and Sanofi-Aventis; and travel/accommodations/meeting expenses unrelated to activities listed with Amgen outside the submitted work. F.G. reports board membership with Sanofi, Boeringher Manheim, Bayer, and Fresenius outside the submitted work. E.P-L. reports board membership and payment for lectures including service on speakers’ bureaus from Roche, Astra Zeneca, and Pfizer and board membership from GSK outside the submitted work. J.A. reports board membership with Roche, Novartis, and Sanofi Aventis outside the submitted work.

    • G.E. current address: Beaujon Hospital, Medical Oncology Unit, Clichy, France.

    • The other authors declare no conflicts of interest.