20. Front-line:
epithelial OV, PP
or FT cancer
Stage III optimal
(macroscopic)
Stage III
suboptimal
Stage IV
N=1,873
• Stratification variables
– GOG performance status
– stage/debulking status
15 months
Paclitaxel (P) 175mg/m2
Carboplatin (C) AUC6
Carboplatin (C) AUC6
Paclitaxel (P) 175mg/m2
Carboplatin (C) AUC6
Paclitaxel (P) 175mg/m2
I
II
III
Arm
1:1:1
Burger RA, et al. Gynecol Oncol. 2013;131:21-6 OV = ovarian; PP = primary peritoneal
AUC: Area Under Curve
GOG: Gynaecologic Oncology Group
R
A
N
D
O
M
I
S
E
Placebo Q3W
Placebo Q3W
Bevacizumab 15mg/kg
Bev 15mg/kg
Bevacizumab in Platinum Sensitive Ca Ovary:
GOG 218 Trial
21. Burger RA, et al. Gynecol Oncol. 2013;131:21-6.
CP
Placebo
(n=625)
Bev + CP Bev
(n=623)
Median PFS (months) 12.0 18.2
HR=0.62 (95% CI, 0.52–0.75) P<0.0001
ITT PFS :Significantly increased PFS with
continued Bevacizumab compared to
standard chemotherapy
GOG 218: Outcomes
CP Placebo
(n=625)
Bev + CP Bev
(n=623)
Median OS (months) 40.6 43.8
HR=0.62 (95% CI, 0.75–1.04) P<0.0641
Median OS trending towards benefit in ITT
population
22. Bevacizumab in Platinum Resistant Ca
Ovary: AURELIA Trial
Randomized Phase III clinical trial in Platinum Resistant Ovarian Cancer
Bevacizumab
10 mg/kg q2w*
+ chemotherapy
(n=179)
Chemotherapy
(n=182)
PD
PD
Chemotherapy options:
Paclitaxel 80 mg/m2 days 1, 8, 15, and 22 q4w
Topotecan 4 mg/m2 days 1, 8, and 15 q4w
(or 1.25 mg/m2 days 1-5 q3w)
Pegylated liposomal doxorubicin 40 mg/m2 day 1 q4w
Chemotherapy
prior to
randomization
• Paclitaxel
• Topotecan
• PLD
Platinum-resistant,
recurrent epithelial ovarian,
fallopian tube, or primary
peritoneal cancer that
recurred within 6months
from the most recent
Platinum-based therapy
• ≤2 prior CT regimens
• ECOG PS 0-2
• No evidence of recto-
sigmoid involvement by
pelvic examination or
bowel involvement on CT
scan or clinical symptoms
of bowel obstruction
(N=361)
R
A
N
D
O
M
I
S
E
Pujade-Lauraine E, et al. J Clin Oncol. 2014;32:1302-1308
33. Take Home Message
• Surgery and chemotherapy is the key to
management
• Highly responsive to chemotherapy
• Relapses are common
• Antiangiogenesis Therapy is the cornerstone
of relapsed ca ovary treatment
• Ca Ovary : The new chronic disease
* Adverse events were those with onset between cycle 2 and 30 days after the date of the last treatment. CNS denotes
central nervous system.
† Gastrointestinal events of grade 2 or greater were gastrointestinal-wall disruption: perforation, fistula, necrosis, or anastomotic
leak.
‡ Hypertension of grade 2 or greater consisted of recurrent or continuous hypertension for a period of more than 24
hours or symptomatic increase in blood pressure by more than 20 mm Hg (diastolic) or to over 150/100 mm Hg if the
blood pressure was previously within the normal range.
§ P<0.05 for the comparison with the control group.
