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Abstract
Introduction With the increasing use of PARPi, clinical cases of PARPi resistance and recurrence among OC patients have become more common. Traditional chemotherapy has proven effective in cases of OC recurrence after PARPi treatment. However, the effectiveness of combining bevacizumab with chemotherapy for this purpose remains uncertain, as comparative trials of the two treatments have yet to be widely published. In this study, we conducted a retrospective evaluation of both treatment strategies.
Methods The study enrolled 41 OC patients who experienced relapse after PARPi treatment and subsequently received chemotherapy, with or without Bevacizumab, at a single institution. Baseline levels were found to be balanced between the two groups. Kaplan-Meier analysis and Cox regression were employed to compare progression-free survival (PFS) and overall survival (OS) for both treatments.
Results Both groups were well matched in all parameters. The hazard ratio (HR) for PFS events in patients was 0.482 (95% CI, 0.247 to 0.942; unstratified log-rank P=0.020). The median PFS was 11 months for the bevacizumab arm vs. 5 months for chemotherapy alone. Median OS was 11 months with chemotherapy alone versus 15 months with bevacizumab-containing therapy, and the OS HR was 0.573 (95% CI, 0.292 to 1.126). Grade ≥2 hypertension (1/23) and thrombosis (2/23) were more common with bevacizumab, while GI perforation occurred in 4.3% (1/23) of bevacizumab-treated patients.
Conclusion/Implications This study found that in patients who relapsed after PARPi, chemotherapy combined with Bevacizumab led to better survival outcomes, and the side effects were well tolerated. Further randomized controlled trials are needed to confirm these results.
