Final report on serial phase II trials of all-intraperitoneal chemotherapy with or without bevacizumab for women with newly diagnosed, optimally cytoreduced carcinoma of Müllerian origin

C. N. Krasner, C. Castro, R. T. Penson, M. Roche, U. A. Matulonis, M. A. Morgan, C. Drescher, D. K. Armstrong, J. K. Wolfe, H. Lee, J. G. Supko, M. Seiden, M. J. Birrer, D. S. Dizon

Research output: Contribution to journalArticle

Abstract

Background: Intraperitoneal (IP) chemotherapy can improve outcomes for women with optimally cytoreduced epithelial ovarian cancer but toxicities are a concern. We conducted 2 phase 2 trials of an IV/IP regimen using carboplatin and paclitaxel without (Trial A) and with bevacizumab (Trial B). Methods: Both trials consisted of carboplatin AUC 6 day 1, and paclitaxel 60 mg/m 2 on days 1,8, 15 of a 21-day cycle; in Trial B, patients received IV bevacizumab 15 mg/kg every cycle starting cycle 2. Chemotherapy was administered IV for cycle 1 and then IP for all subsequent cycles. Primary objectives included safety and tolerability, pathologic CR rate (Trial A), and the rate of completion of IP cycles of therapy (Trial B). Progression-free (PFS), overall survival (OS), and pharmacokinetic analysis were secondary endpoints. Results: 81 patients were treated on both trials (n = 40 and 41 in trials A and B, respectively). Median age for trials A and B was 59 (range, 36–76) and 55 (range, 19–69) years, respectively. 68% and 85% of patients, respectively for A and B, completed at least 4 cycles of treatment in both trials. Treatment with bevacizumab resulted in higher rates of grade 3 fatigue (37 versus 33%) and grade 3–4 diarrhea (22 versus 8%). Median PFS was 23.5 (95%CI 16.2–35.3) and 25 (95%CI 16.4–42.7) months, respectively; median OS was 68 (95%CI 49.5-NR) and 79.7 (95%CI 59.0–79.7) months, respectively for Trial A and B. Conclusions: Weekly administered IP carboplatin and IP paclitaxel is tolerable and safe with similar activity with and without concommittant bevacizumab in these 2 trials.

Original languageEnglish (US)
Pages (from-to)223-229
Number of pages7
JournalGynecologic oncology
Volume153
Issue number2
DOIs
StatePublished - May 2019

Keywords

  • Bevacizumab
  • Carboplatin
  • Intraperitoneal chemotherapy
  • Ovarian cancer
  • Paclitaxel

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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    Krasner, C. N., Castro, C., Penson, R. T., Roche, M., Matulonis, U. A., Morgan, M. A., Drescher, C., Armstrong, D. K., Wolfe, J. K., Lee, H., Supko, J. G., Seiden, M., Birrer, M. J., & Dizon, D. S. (2019). Final report on serial phase II trials of all-intraperitoneal chemotherapy with or without bevacizumab for women with newly diagnosed, optimally cytoreduced carcinoma of Müllerian origin. Gynecologic oncology, 153(2), 223-229. https://doi.org/10.1016/j.ygyno.2019.02.004