Bevacizumab in Ovarian Cancer

Excerpt

Under the term ‘epithelial ovarian cancer’ or EOC, we usually include a group of malignancies arising from extrauterine Müllerian epithelium (fallopian tube, primary peritoneal and ovarian cancer), which are characterized by peritoneal spread and by their common clinical presentation at advanced stages.[1] Over the past 3 decades, therapeutic strides against these malignancies have been made, not from the use of early detection strategies, but rather following the introduction of the very active platinum compounds and aggressive surgical cytoreduction. Although great efforts are ongoing on the molecular characterization of these tumours, to date, drugs directed to molecular targets have not played a major part in treatment approaches. While carboplatin + paclitaxel chemotherapy regularly achieves eradication of post-surgery residual disease (assessed by non-invasive means), the average durability of these clinical responses barely exceeds 18 months.[2] This remains the major challenge being addressed by our current clinical trials and new drug development. Upon clinical recurrence, particularly if ‘platinum resistant’, the disease is mostly ‘held at bay’ through the sequential application of a multitude of second-line drug regimens that may prolong survival through chronic administration, with variable patient benefit and acceptability.[2] Now enter bevacizumab … …