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Paclitaxel, Carboplatin, and Bevacizumab in Advanced and Recurrent Endometrial Carcinoma
  1. Peter G. Rose, MD*,
  2. Shamshad Ali, MA, MSTAT,
  3. Mehdi Moslemi-Kebria, MD and
  4. Fiona Simpkins, MD§
  1. *Cleveland Clinic Foundation, Cleveland, OH;
  2. Roswell Park Cancer Institute, Buffalo, NY;
  3. Division of Gynecologic Oncology, Department of Surgery, City of Hope National Medical Center, Duarte, CA; and
  4. §University of Pennsylvania, Philadelphia, PA.
  1. Address correspondence and reprint requests to Peter G. Rose, MD, Cleveland Clinic Foundation, 9500 Euclid Avenue A81, Cleveland, OH 44195. E-mail: rosep@ccf.org.

Abstract

Objective The aim of this study was to evaluate the efficacy of adding bevacizumab to paclitaxel and carboplatin and as maintenance in a larger cohort of patients with advanced or recurrent endometrial carcinoma.

Methods We retrospectively identified endometrial cancer patients treated with paclitaxel (175 mg/m2 per 3 hours), carboplatin (area under the curve, 5) and bevacizumab (15 mg/kg) and maintenance bevacizumab treated in a post–protocol treatment cohort and evaluated them with our previously published phase 2 trial of this regimen.

Results Twenty-seven additional patients were identified; 19 received the regimen as first-line therapy, and 8 received the regimen as second-line therapy after prior paclitaxel and carboplatin. The 19 patients who received first-line therapy were analyzed alone and with the 15 patients enrolled on protocol. The 2 cohorts were similar with respect to risk factors. Overall survival curves were not statistically different between the protocol and the postprotocol patients (log-rank test; P > 0.1). Collectively, a total of 266 courses (median, 6 courses; range, 1–20 courses) of carboplatin, paclitaxel, and bevacizumab combination therapy and 305 courses (median, 16 courses; range, 0–45courses) of bevacizumab maintenance therapy were administered as first-line therapy. Collectively, the median progression-free survival was 20 months, and median overall survival was 56 months. Among 29 patients with measurable disease, the response rate was 82.8% (95% confidence interval, 69.0%–96.5%; 15 complete responses and 9 partial responses). Among the 8 patients who received paclitaxel and carboplatin and bevacizumab as second-line therapy after paclitaxel and carboplatin, the response rate was 87.5% (6 complete responses, 1 partial response). Their median progression-free survival and median overall survival were not reached after a median follow-up of 23.5 months.

Conclusions Although there are inherent limitations to small retrospective studies, this second analysis confirms the high response rate, progression-free survival, and overall survival in the bevacizumab, paclitaxel, and carboplatin regimen as first-line therapy in advanced and recurrent endometrial carcinoma.

  • Endometrial cancer
  • Bevacizumab
  • Carboplatin
  • Chemotherapy
  • First-line
  • Paclitaxel
  • Second-line

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Footnotes

  • The authors declare no conflicts of interest.

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