A prospective feasibility study of radiation and concurrent bevacizumab for recurrent endometrial cancer

Akila N. Viswanathan, Hang Lee, Ross Berkowitz, Suzanne Berlin, Susanna Campos, Colleen Feltmate, Neil Horowitz, Michael Muto, Cheryl A. Sadow, Ursula Matulonis

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives To determine the toxicity and survival rates in a trial of concurrent bevacizumab and external beam radiation (EB) for patients with recurrent endometrial or ovarian cancer. Methods Nineteen women with recurrent endometrial (n = 15) or ovarian (n = 4) cancer with gross disease involving the vaginal cuff, and/or pelvic nodes and/or para-aortic nodes, cancer were enrolled between 2008 and 2010. All patients received bevacizumab during radiation. Toxicity was assessed at baseline, weekly during treatment and every 3 months for at least 1 year after treatment. Results All patients completed EB on schedule. For the 15 patients with recurrent endometrial cancer, the 1- and 3-year progression-free survival (PFS was) 80%/67% and overall survival (OS) was 93%/80%. Patients that had a vaginal cuff recurrence alone had a 1- and 3-year PFS of 75%/63% and OS of 100%/75%. Two patients with pelvic node involvement did not recur throughout the entire follow-up period. The 5 patients with para-aortic node involvement had a 1- and 3-year PFS of 80%/60% and OS of 80%/80%. Of the 4 ovarian cancer patients 3 relapsed with 1- and 3-year PFS of 80%/40% and OS of 100%/60%. Toxicities included thrombosis and 1 embolic event in the setting of metastastic disease. No gastrointestinal perforations were noted. Conclusions Delivering bevacizumab with concurrent radiation provides excellent local tumor control and survival for women with recurrent endometrioid endometrial cancer, particularly those with unresectable nodes. Caution must be used in those at highest risk of developing metastatic disease given the increased risk of thromboembolic events. This regimen may be considered for recurrent gynecologic malignancies in future trials.

Original languageEnglish (US)
Pages (from-to)55-60
Number of pages6
JournalGynecologic oncology
Volume132
Issue number1
DOIs
StatePublished - Jan 2014
Externally publishedYes

Keywords

  • Bevacizumab
  • Gynecologic malignancies
  • Radiation

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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