RT Journal Article
SR Electronic
T1 Arthralgia in patients with ovarian cancer treated with bevacizumab and chemotherapy
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP ijgc-2020-001540
DO 10.1136/ijgc-2020-001540
A1 Jole Ventriglia
A1 Immacolata Paciolla
A1 Carmela Pisano
A1 Rosa Tambaro
A1 Sabrina Chiara Cecere
A1 Marilena Di Napoli
A1 Laura Attademo
A1 Laura Arenare
A1 Anna Spina
A1 Daniela Russo
A1 Daniela Califano
A1 Nunzia Simona Losito
A1 Sergio Venanzio Setola
A1 Elisena Franzese
A1 Ferdinando De Vita
A1 Michele Orditura
A1 Sandro Pignata
YR 2020
UL http://ijgc.bmj.com/content/early/2020/08/12/ijgc-2020-001540.abstract
AB Background Chemotherapy with carboplatin, paclitaxel, and bevacizumab is the standard therapy for patients with advanced stage ovarian cancer wild-type BRCA after primary surgery. The most frequent side effects of bevacizumab in this setting are hypertension, thrombosis, hemorrhage, and proteinuria, while arthralgia has been poorly described.Objective To examine the incidence, duration, and reversibility of arthralgia.Patients and methods A retrospective analysis was performed to describe the occurrence and outcome of arthralgia in 114 patients with advanced ovarian cancer, given first-line treatment with a combination of carboplatin, paclitaxel, and bevacizumab. Statistical analysis was performed to investigate a possible prognostic role of arthralgia, with progression-free survival as endpoint.Results 47 of 114 patients (41%) developed arthralgia during therapy. All patients had grade 1 or grade 2 arthralgia. Toxicity persisted after the end of bevacizumab in 17/47 patients (36%). Median progression-free survival for patients without arthralgia was 18 months (95% CI 14 to 24) compared with 29 months (95% CI 21 to not reached) for patients experiencing arthralgia (p=0.03). In order to avoid possible biases related to treatment duration, a multivariable Cox proportional hazards model including toxicity as a time dependent variable and age, stage, and residual disease after primary surgery was performed. In this model no variable showed a statistically significant association with progression-free survival.Conclusion A high incidence of arthralgia (41%) was found and although rogression-free survival was worse for those patients who developed arthralgia, this was not maintained on multivariate analysis. Guidelines for treatment of this adverse event are needed.