Bevacizumab with or after chemotherapy for platinum-resistant recurrent ovarian cancer: Exploratory analyses of the AURELIA trial

Aristotelis Bamias, E. Gibbs, C. Khoon Lee, L. Davies, M. Dimopoulos, F. Zagouri, A. S. Veillard, J. Kosse, A. Santaballa, M. R. Mirza, G. Tabaro, I. Vergote, H. Bloemendal, M. Lykka, A. Floquet, V. Gebski, E. Pujade-Lauraine

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: In the open-label randomized phase III AURELIA trial, adding bevacizumab to chemotherapy for platinum-resistant ovarian cancer (PROC) significantly improved progression-free survival and response rate versus chemotherapy alone, but not overall survival (OS). We explored the effect of bevacizumab use after disease progression (PD) in patients randomized to chemotherapy alone. Patients and methods: In AURELIA, 361 women with PROC were randomized to chemotherapy alone or with bevacizumab. Patients initially randomized to chemotherapy were offered bevacizumab after PD. Post hoc analyses assessed efficacy and safety in three subgroups: chemotherapy alone, chemotherapy followed by bevacizumab after PD, and chemotherapy plus bevacizumab at randomization. Results: Of the 182 patients randomized to chemotherapy alone, 72 (40%) received bevacizumab after PD and 110 (60%) never received bevacizumab. There were no significant differences in patient and disease characteristics between these subgroups at baseline or the time of PD. Compared with patients never receiving bevacizumab, the risk of death was significantly reduced in patients receiving bevacizumab either upfront with chemotherapy [hazard ratio (HR) = 0.68, 95% confidence interval (CI) 0.52-0.90] or after PD (HR = 0.60, 95% CI 0.43-0.86). The tolerability of bevacizumab was similar with administration upfront or after PD. Conclusions: Post-PD bevacizumab use may have confounded OS results in AURELIA. In these exploratory analyses of non-randomized subgroups, bevacizumab use, either with chemotherapy or after PD on chemotherapy alone, improved OS compared with no bevacizumab. Combining bevacizumab with chemotherapy at first appearance of platinum resistance maximises the likelihood of patients receiving this active treatment for PROC.

Original languageEnglish
Article numbermdx228
Pages (from-to)1842-1848
Number of pages7
JournalAnnals of Oncology
Volume28
Issue number8
DOIs
Publication statusPublished - Aug 1 2017

Fingerprint

Platinum
Ovarian Neoplasms
Drug Therapy
Bevacizumab
Survival
Confidence Intervals
Random Allocation
Disease-Free Survival
Disease Progression
Survival Rate

Keywords

  • Bevacizumab
  • Combination therapy
  • Overall survival
  • platinum-resistant ovarian cancer
  • Sequence
  • ovarian cancer

ASJC Scopus subject areas

  • Hematology
  • Oncology

Cite this

Bamias, A., Gibbs, E., Khoon Lee, C., Davies, L., Dimopoulos, M., Zagouri, F., ... Pujade-Lauraine, E. (2017). Bevacizumab with or after chemotherapy for platinum-resistant recurrent ovarian cancer: Exploratory analyses of the AURELIA trial. Annals of Oncology, 28(8), 1842-1848. [mdx228]. https://doi.org/10.1093/annonc/mdx228

Bevacizumab with or after chemotherapy for platinum-resistant recurrent ovarian cancer : Exploratory analyses of the AURELIA trial. / Bamias, Aristotelis; Gibbs, E.; Khoon Lee, C.; Davies, L.; Dimopoulos, M.; Zagouri, F.; Veillard, A. S.; Kosse, J.; Santaballa, A.; Mirza, M. R.; Tabaro, G.; Vergote, I.; Bloemendal, H.; Lykka, M.; Floquet, A.; Gebski, V.; Pujade-Lauraine, E.

In: Annals of Oncology, Vol. 28, No. 8, mdx228, 01.08.2017, p. 1842-1848.

Research output: Contribution to journalArticle

Bamias, A, Gibbs, E, Khoon Lee, C, Davies, L, Dimopoulos, M, Zagouri, F, Veillard, AS, Kosse, J, Santaballa, A, Mirza, MR, Tabaro, G, Vergote, I, Bloemendal, H, Lykka, M, Floquet, A, Gebski, V & Pujade-Lauraine, E 2017, 'Bevacizumab with or after chemotherapy for platinum-resistant recurrent ovarian cancer: Exploratory analyses of the AURELIA trial', Annals of Oncology, vol. 28, no. 8, mdx228, pp. 1842-1848. https://doi.org/10.1093/annonc/mdx228
Bamias, Aristotelis ; Gibbs, E. ; Khoon Lee, C. ; Davies, L. ; Dimopoulos, M. ; Zagouri, F. ; Veillard, A. S. ; Kosse, J. ; Santaballa, A. ; Mirza, M. R. ; Tabaro, G. ; Vergote, I. ; Bloemendal, H. ; Lykka, M. ; Floquet, A. ; Gebski, V. ; Pujade-Lauraine, E. / Bevacizumab with or after chemotherapy for platinum-resistant recurrent ovarian cancer : Exploratory analyses of the AURELIA trial. In: Annals of Oncology. 2017 ; Vol. 28, No. 8. pp. 1842-1848.
@article{18b5244c502d4d7ead6b01a486600749,
title = "Bevacizumab with or after chemotherapy for platinum-resistant recurrent ovarian cancer: Exploratory analyses of the AURELIA trial",
abstract = "Background: In the open-label randomized phase III AURELIA trial, adding bevacizumab to chemotherapy for platinum-resistant ovarian cancer (PROC) significantly improved progression-free survival and response rate versus chemotherapy alone, but not overall survival (OS). We explored the effect of bevacizumab use after disease progression (PD) in patients randomized to chemotherapy alone. Patients and methods: In AURELIA, 361 women with PROC were randomized to chemotherapy alone or with bevacizumab. Patients initially randomized to chemotherapy were offered bevacizumab after PD. Post hoc analyses assessed efficacy and safety in three subgroups: chemotherapy alone, chemotherapy followed by bevacizumab after PD, and chemotherapy plus bevacizumab at randomization. Results: Of the 182 patients randomized to chemotherapy alone, 72 (40{\%}) received bevacizumab after PD and 110 (60{\%}) never received bevacizumab. There were no significant differences in patient and disease characteristics between these subgroups at baseline or the time of PD. Compared with patients never receiving bevacizumab, the risk of death was significantly reduced in patients receiving bevacizumab either upfront with chemotherapy [hazard ratio (HR) = 0.68, 95{\%} confidence interval (CI) 0.52-0.90] or after PD (HR = 0.60, 95{\%} CI 0.43-0.86). The tolerability of bevacizumab was similar with administration upfront or after PD. Conclusions: Post-PD bevacizumab use may have confounded OS results in AURELIA. In these exploratory analyses of non-randomized subgroups, bevacizumab use, either with chemotherapy or after PD on chemotherapy alone, improved OS compared with no bevacizumab. Combining bevacizumab with chemotherapy at first appearance of platinum resistance maximises the likelihood of patients receiving this active treatment for PROC.",
keywords = "Bevacizumab, Combination therapy, Overall survival, platinum-resistant ovarian cancer, Sequence, ovarian cancer",
author = "Aristotelis Bamias and E. Gibbs and {Khoon Lee}, C. and L. Davies and M. Dimopoulos and F. Zagouri and Veillard, {A. S.} and J. Kosse and A. Santaballa and Mirza, {M. R.} and G. Tabaro and I. Vergote and H. Bloemendal and M. Lykka and A. Floquet and V. Gebski and E. Pujade-Lauraine",
year = "2017",
month = "8",
day = "1",
doi = "10.1093/annonc/mdx228",
language = "English",
volume = "28",
pages = "1842--1848",
journal = "Annals of Oncology",
issn = "0923-7534",
publisher = "NLM (Medline)",
number = "8",

}

TY - JOUR

T1 - Bevacizumab with or after chemotherapy for platinum-resistant recurrent ovarian cancer

T2 - Exploratory analyses of the AURELIA trial

AU - Bamias, Aristotelis

AU - Gibbs, E.

AU - Khoon Lee, C.

AU - Davies, L.

AU - Dimopoulos, M.

AU - Zagouri, F.

AU - Veillard, A. S.

AU - Kosse, J.

AU - Santaballa, A.

AU - Mirza, M. R.

AU - Tabaro, G.

AU - Vergote, I.

AU - Bloemendal, H.

AU - Lykka, M.

AU - Floquet, A.

AU - Gebski, V.

AU - Pujade-Lauraine, E.

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Background: In the open-label randomized phase III AURELIA trial, adding bevacizumab to chemotherapy for platinum-resistant ovarian cancer (PROC) significantly improved progression-free survival and response rate versus chemotherapy alone, but not overall survival (OS). We explored the effect of bevacizumab use after disease progression (PD) in patients randomized to chemotherapy alone. Patients and methods: In AURELIA, 361 women with PROC were randomized to chemotherapy alone or with bevacizumab. Patients initially randomized to chemotherapy were offered bevacizumab after PD. Post hoc analyses assessed efficacy and safety in three subgroups: chemotherapy alone, chemotherapy followed by bevacizumab after PD, and chemotherapy plus bevacizumab at randomization. Results: Of the 182 patients randomized to chemotherapy alone, 72 (40%) received bevacizumab after PD and 110 (60%) never received bevacizumab. There were no significant differences in patient and disease characteristics between these subgroups at baseline or the time of PD. Compared with patients never receiving bevacizumab, the risk of death was significantly reduced in patients receiving bevacizumab either upfront with chemotherapy [hazard ratio (HR) = 0.68, 95% confidence interval (CI) 0.52-0.90] or after PD (HR = 0.60, 95% CI 0.43-0.86). The tolerability of bevacizumab was similar with administration upfront or after PD. Conclusions: Post-PD bevacizumab use may have confounded OS results in AURELIA. In these exploratory analyses of non-randomized subgroups, bevacizumab use, either with chemotherapy or after PD on chemotherapy alone, improved OS compared with no bevacizumab. Combining bevacizumab with chemotherapy at first appearance of platinum resistance maximises the likelihood of patients receiving this active treatment for PROC.

AB - Background: In the open-label randomized phase III AURELIA trial, adding bevacizumab to chemotherapy for platinum-resistant ovarian cancer (PROC) significantly improved progression-free survival and response rate versus chemotherapy alone, but not overall survival (OS). We explored the effect of bevacizumab use after disease progression (PD) in patients randomized to chemotherapy alone. Patients and methods: In AURELIA, 361 women with PROC were randomized to chemotherapy alone or with bevacizumab. Patients initially randomized to chemotherapy were offered bevacizumab after PD. Post hoc analyses assessed efficacy and safety in three subgroups: chemotherapy alone, chemotherapy followed by bevacizumab after PD, and chemotherapy plus bevacizumab at randomization. Results: Of the 182 patients randomized to chemotherapy alone, 72 (40%) received bevacizumab after PD and 110 (60%) never received bevacizumab. There were no significant differences in patient and disease characteristics between these subgroups at baseline or the time of PD. Compared with patients never receiving bevacizumab, the risk of death was significantly reduced in patients receiving bevacizumab either upfront with chemotherapy [hazard ratio (HR) = 0.68, 95% confidence interval (CI) 0.52-0.90] or after PD (HR = 0.60, 95% CI 0.43-0.86). The tolerability of bevacizumab was similar with administration upfront or after PD. Conclusions: Post-PD bevacizumab use may have confounded OS results in AURELIA. In these exploratory analyses of non-randomized subgroups, bevacizumab use, either with chemotherapy or after PD on chemotherapy alone, improved OS compared with no bevacizumab. Combining bevacizumab with chemotherapy at first appearance of platinum resistance maximises the likelihood of patients receiving this active treatment for PROC.

KW - Bevacizumab

KW - Combination therapy

KW - Overall survival

KW - platinum-resistant ovarian cancer

KW - Sequence

KW - ovarian cancer

UR - http://www.scopus.com/inward/record.url?scp=85029290444&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85029290444&partnerID=8YFLogxK

U2 - 10.1093/annonc/mdx228

DO - 10.1093/annonc/mdx228

M3 - Article

AN - SCOPUS:85029290444

VL - 28

SP - 1842

EP - 1848

JO - Annals of Oncology

JF - Annals of Oncology

SN - 0923-7534

IS - 8

M1 - mdx228

ER -