Objectives Bevacizumab is used in combination with chemotherapy in advanced stage ovarian carcinoma. Clinical trials have shown improved progression-free survival in these patients. Nevertheless, its impact on overall survival (OS) remains unclear. Hence, we aimed to evaluate the impact of bevacizumab on OS in real-world patients, treated outside of clinical trials.
Methods A retrospective cohort study of all patients with advanced stage epithelial ovarian carcinoma (Stage III and IV) treated in one university affiliated medical center (2000–6/2017). Demographics and treatment outcome were compared between patients receiving bevacizumab in addition to standard chemotherapy to those treated with chemotherapy alone before the incorporation of bevacizumab into clinical practice. P value < 0.05 was considered significant.
Results Overall, 188 patients met inclusion criteria. Of them, 59 (31.4%) received bevacizumab and 129 (68.6%) received chemotherapy only. Median age and levels of CA-125 at diagnosis did not differ between patients receiving bevacizumab and those who did not (61 vs. 62 years, p=0.75 and 638 vs 561 U/mL, p=0.78, respectively). Rates of stage IV disease were similar between groups (16.9% vs 12.4%, p=0.4). Rates of optimal cytoreduction (<1 cm largest residual disease) were comparable between groups (79.6% vs 84.1%, p=0.48). The median OS for the whole cohort was 5.9 years. Using Time-varying Cox model, the use of bevacizumab did not improve OS (HR 0.46, 95% CI 0.17–1.25, p=0.13).
Conclusions In our center, the addition of bevacizumab to standard chemotherapy in patients with advanced stage ovarian carcinoma had no impact on OS.
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