Metronomic cyclophosphamide with Avastin for ovarian cancer – pro

Patients with ovarian cancer that has recurred or progressed following prior therapies,  have unfavorable long-term outcomes with standard therapies. Although additional chemotherapy can be used to treat these patients, they often have minimal anti-cancer responses as well as side effects from treatment. Initial study of Avastin focused on this unfavourable group. The previous trials included Avastin with metronomic cyclophosphamide and one with a taxane.  Since then several retrospective reviews, small phase II trials and case reports had been published, They generally conclude that this is a tolerable and effective combination but more study is needed.

NCCN supports second line use of Avastin alone or in combination – on p. OV-D, 1.) and Cyclophosphamide (cytoxan) together without causing serious side effects.

 

There is an ongoing trial: Sequential Angiogenic Blockade for the Treatment of Recurrent Mullerian Malignancies, NCT00856180. The purpose of this study is to see if it is safe to give Avastin (bevacizumab) and Cyclophosphamide (cytoxan) together without causing serious side effects.

Perren T, Swart AM, Pfisterer J, et al: ICON7: A phase III randomized gynaecologic cancer intergroup trial of concurrent bevacizumab and chemotherapy followed by maintenance bevacizumab versus chemotherapy alone in women with newly diagnosed epithelial ovarian cancer, primary peritoneal cancer, or fallopian tube cancer. Program and abstracts of the 35th European Society for Medical Oncology (ESMO) Congress; October 8-12, 2010; Milan, Italy. Abstract LBA4.

Burger RA, Brady MF, Bookman MA, et al. Phase III trial of bevacizumab (BEV) in the primary treatment of advanced epithelial ovarian cancer (EOC), primary peritoneal cancer (PPC), or fallopian tube cancer (FTC): A Gynecologic Oncology Group study. J Clin Oncol. 2010;28:abstract LBA1, ASCO Annual Meeting Proceedings (Post-Meeting Edition). Available at: http://meeting.ascopubs.org/cgi/content/abstract/28/18_suppl/LBA1

Sánchez-Muñoz A, Mendiola C, Pérez-Ruiz E, Rodríguez-Sánchez CA, Jurado JM, Alonso-Carrión L, Ghanem I, de Velasco G, Quero-Blanco C, Alba E. Bevacizumab plus low-dose metronomic oral cyclophosphamide in heavily pretreated patients with recurrent ovarian cancer.
Oncology. 2010;79(1-2):98-104. Epub 2010 Nov 15.

Burger R, Brady MF, Bookman MA, et al: Phase III trial of bevacizumab (BEV) in the primary treatment of advanced epithelial ovarian cancer (EOC), primary peritoneal cancer (PPC), or fallopian tube cancer (FTC): A Gynecologic Oncology Group study. 2010 ASCO Annual Meeting. Abstract LBA1. Presented June 6, 2010.

Cohn DE, Valmadre S, Resnick KE, et al. Bevacizumab and weekly taxane chemotherapy demonstrates activity in refractory ovarian cancer. Gynecologic Oncology. 2006;March 7;

 

 

 

 

 

;

Participate in our Forums

To ask questions or participate in a discussion, please visit our Forums. You must LOGIN to participate.

Help Us Help Others

You can become a Site Sponsor. Or you may wish to support our work with a Donation.

Focused Articles For You

Lay Portal

Professional