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.
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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.
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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.
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