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A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS
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A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS

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H. Anishchanka …

H. Anishchanka
A CASE SERIES OF BEVACIZUMAB IN COMPLEX THERAPY IN PATIENTS WITH ADVANCED SEROUS EPITHELIAL OVARIAN CANCER IN BELARUS

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  • 1. A CASE SERIES OF BEVACIZUMABIN COMPLEX THERAPY INPATIENTS WITH ADVANCEDSEROUS EPITHELIAL OVARIANCANCER IN BELARUSgraduate student, Department of Oncology H. Anishchankasupervisor:associate professor, Department of Oncology, MD S. ShelkovichBelarusian Medical Academyof Postgraduate EducationMinsk2013
  • 2. Ovarian cancer remains a pressingproblem in oncology and the leadingcause of death from gynecologicmalignancy.
  • 3. Incidence in Belarus15,416,218,116,618,319,4141618202001 2005 2010BelarusMinsk
  • 4. •The main role in the treatment ofovarian carcinoma belongs tosurgery and chemotherapy.
  • 5. MortalityAccording to the cumulative population-based cancer registries in Europeone-year survival rate of patients withovarian cancer is 63%three-year- 41%five-year- 35%
  • 6. 703 new cases of ovarian cancer wererevealed in Minsk since 2006 to 2010histological cytologicalverification verification624 (89%) 79 (11%)serous epithelial ovarian cancer456 (73%)
  • 7. Distribution by stagen=45620,0%80,00%
  • 8. DEBULKINGcубоптимальнаяполная0,00%10,00%20,00%30,00%40,00%поздний ракsuboptimal;35,60%optimal ; 34,80%complete;29,60%
  • 9. Relapse after complete debulking33%advanced cancer N=107
  • 10. OVERALL SURVIVALМедиана 38,9±3,6 мес.
  • 11. OVERALL SURVIVAL
  • 12. OVERALL SURVIVAL
  • 13. OVERALL SURVIVAL
  • 14. A lot of novel drugs haveappeared for the treatmentof ovarian cancer, includingtarget drugs.The most perspective groupis antiangiogenic drugs.
  • 15. The most studied antiangiogenic drug isbevacizumab (Avastin) – a recombinanthumanised monoclonal antibody thattargets VEGF. Bevacizumab inhibitsbinding of VEGF to its receptors on thesurface of endothelial cells, thus decreasingtumor vascularity and growth.
  • 16. AIMto assess the safety and activity ofbevacizumab in the first-linetreatment of advanced serousepithelial ovarian cancer
  • 17. Характеристики Количество больныхВозраст(лет):≤45>45средний3 (50 %)3 (50%)56,6 ± 12Распространениеопухоли (FIGO): IIС (T2CN0M0)IIIС(T3CN0M0)IIIС (T3CN1M0)2 (33,3%)2 (33,3%)2 (33,3%)Степень дифференцировки:G1G2G3G41 (17%)1 (17%)2 (33,3%)2 (33,3%)PATIENTSFEATURES PATIENTSAge(years):≤45>45average3 (33 %)6 (77%)56,6 ± 12FIGO :IIС (T2CN0M0)IIIС (T2CN1M0)IIIС (T3CN0M0)IIIС (T3CN1M0)1 (11,1%)1 (11,1%)5 (55,6%)2 (22,2%)Differentiation:G1G2G3G42 (22,2%)1 (11,1%)4 (44,5%)2 (22,2%)
  • 18. DEBULKINGoptimal suboptimal >2sm33, 3% (3) 11,1% (1) 55,6% (5)
  • 19. CHEMOTHERAPYCHEMOTHERAPY1cycle – paclitaxel (175 mg/м2) + carboplatin (AUC 5-6)2cycle - paclitaxel (175 mg/м2) + carboplatin (AUC 5-6)+ bevacizumab (7,5 мg/kg)3cycle - paclitaxel (175 mg/м2) + carboplatin (AUC 5-6)+ bevacizumab (7,5 мg/kg)4cycle - paclitaxel (175 mg/м2) + carboplatin (AUC 5-6)+ bevacizumab (7,5 мg/kg)5cycle - paclitaxel (175 mg/м2) + carboplatin (AUC 5-6)6cycle - paclitaxel (175 mg/м2) + carboplatin (AUC 5-6)
  • 20. ADVERSE REACTIONS :1. Alopecia2. Nausea / vomiting3. Stomatitis4. Paresthesia5. Angiostaxis6. Increased blood pressure
  • 21. ADVERSE REACTIONSADVERSE REACTIONS0%20%40%60%80%100%
  • 22. BloodpressureBeforesurgeryAftersurgery1 cycleCT2cycleCT3cycleCT4cycleCT5cycleCT6cycleCTPatient 6100/70 105/70 110/70 140/100 140/90 140/100 110/70 110/75Patient2120/80 125/75 120/75 125/80 120/80 115/75 120/70 120/80Patient 4145/90 150/80 140/90 180/100 180/100 180/100 140/80 140/75Patient 1140/90 145/85 140/80 180/100 180/100 180/100 140/90 140/80Patient 3110/70 115/70 115/70 120/70 120/75 115/75 120/80 115/70Patient 5130/80 125/80 120/75 120/80 130/75 120/80 120/70 120/75Blood Pressure
  • 23. Hematologic toxicity was notrevealed.
  • 24. Нв, g/l BeforesurgeryAftersurgery1 cycleCT2cycle CT3cycleCT4cycleCT5cycleCT6cycleCTPatient 688 85 104 106 116 127 117 128Patient2107 104 112 125 132 112 124 119Patient 4111 114 120 130 125 113 125 123Patient 1111 104 107 109 103 125 118 119Patient 387 98 112 125 123 135 124 130Patient 5130 107 104 104 117 125 103 109105 102 109 116 119 123 119 121Hemoglobin
  • 25. PLTх109/l BeforesurgeryAftersurgery1 cycleCT2cycle CT3cycleCT4cycleCT5cycleCT6cycleCTPatient 6321 312 377 232 181 187 259 254Patient2415 301 373 285 343 143 124 147Patient 4321 121 125 125 182 103 128 194Patient 1210 301 199 183 204 205 283 300Patient 3340 340 373 285 325 363 126 190Patient 5245 165 150 109 142 100 178 308308 256 232Platelets
  • 26. WBC, х109/l BeforesurgeryAftersurgery1 cycleCT2cycleCT3cycleCT4cycleCT5cycleCT6cycleCTPatient 65,1 5 4,13 2,77 5,35 4,3 2,59 3,62Patient26,4 10,53 6,82 5,14 7,38 5,4 4,5 4,6Patient 46,9 4,1 5,23 8,31 4,92 2,54 4,69 3,29Patient 16,7 10,53 3,8 7,5 2,63 5,6 6,66 5,4Patient 311,7 9,5 6,82 6,82 7,2 7,21 5,1 3,9Patient 54,8 3,5 4,22 3,37 4,74 3,97 4,4 2,636,93 7,2 5,17 5,65 5,37 4,84 4,66 3,9White blood cells
  • 27. The direct effect
  • 28. СА-125, Е/ml BeforesurgeryAftersurgery1 cycleCT2cycleCT3cycleCT4cycleCT5cycleCT6cycleCTPatient 6133,4 23,72 5,26 4,36 5,34 6,7 5,76 8,57Patient2282 276,1 1,85 1,81 2,17 1,81 2,27 0,73Patient 4208,4 80 76,6 23,31 24,2 14,4 10,0 9,82Patient 1284,5 276,1 26,5 20,2 10,1 9,8 7,2 4,3Patient 31119 543 354 27,9 26,3 10,2 9,1 5,3Patient 5208 70,3 16,4 17,76 13,65 12,1 10,9 4,9372,6 7,6СА-125
  • 29. The direct effect was assessed bycontrast enhanced CT
  • 30. CONTROL outbreaks:localization № cutoff diameterperitoneum 16 19mmporta of hepar 32 52mmThe sum of the largest diameter 71mmLymph nodesRight retroperitoneal lymph node 75 30mmThe sum of the diameter 30mmSum of the diameters of all the control outbreakes101mmPatient 1 before treatment
  • 31. Рисунок КТ
  • 32. Patient 1 after treatmentCONTROL outbreaks:localization № cutoff diameterperitoneum 15 14mmporta of hepar 33 26mmThe sum of the largest diameter 40mmLymph nodesRight retroperitoneal lymph node 73 13mmThe sum of the diameter 13mmSum of the diameters of all the control outbreakes53mm
  • 33. Рисунок КТ
  • 34. Patient 3 before treatmentCONTROL outbreaks:localization № cutoff diameterPeritoneum on the right 76 18mmPeritoneum on the left 71 21mmThe sum of the largest diameter 39mmLymph nodesThe sum of the diameterSum of the diameters of all the control outbreakes39mm
  • 35. Рисунок КТ
  • 36. Patient 3 after treatmentCONTROL outbreaks:localization № cutoff diameterPeritoneum on the right 76 12mmPeritoneum on the left 67 17mmThe sum of the largest diameter 29mmLymph nodesThe sum of the diameterSum of the diameters of all the control outbreakes29mm
  • 37. Рисунок КТ
  • 38. Patient 4 before treatmentCONTROL outbreaks:localization № cutoff diameterThe sum of the largest diameterLymph nodespara-aortic lymph node 58 11The sum of the diameterSum of the diameters of all the control outbreakes 11mm
  • 39. Patient 4 after treatmentCONTROL outbreaks:localization № cutoff diameterThe sum of the largest diameterLymph nodespara-aortic lymph node 58 7The sum of the diameterSum of the diameters of all the control outbreakes 7mm
  • 40. Patient 5 before treatmentCONTROL outbreaks:localization № cutoff diameterThe sum of the largest diameterLymph nodesLeft para-aortic lymph node 65 18Left para-aortic lymph node 77 19The sum of the diameterSum of the diameters of all the control outbreakes 37mm
  • 41. Patient 5 after treatmentCONTROL outbreaks:localization № cutoff diameterThe sum of the largest diameterLymph nodesLeft para-aortic lymph node 60 14Left para-aortic lymph node 67 11The sum of the diameterSum of the diameters of all the control outbreakes 25mm
  • 42. StageFirstdebulkingСА125first BP RECISTСА125finishSecondbulking ResponsePatient 6 T2CN0M0G3 optimal 133,4 140/100 8,57 нетCompleteresponsePatient2 T3CN0M0G1 optimal 282 125/80 0,73 нетCompleteresponsePatient 4 T2CN1M0G4 suboptimal 208,4 180/100 9,82 +CompleteresponsePatient 1T3CN1M0G3 >2sm 284,5 180/100 101/53 4,3 +Partialresponse(90% )Patient 3T3CN0M0G2>2sm1119 120/70 39/29 5,3 +Partialresponse(50%)Patient 5 T3CN1M0G4>2sm208 120/80 37/25 4,9 +Completeresponse
  • 43. CONCLUSIONS:• Bevacizumab in combination with standardchemotherapy was well tolerated and active infirst-line treatment of advanced serous epithelialovarian cancer.• Study continues to find out optimal regimen ofbevacizumab.

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