Feasibility and outcome of interval debulking surgery (IDS) after carboplatin-paclitaxel-bevacizumab (CPB): A subgroup analysis of the MITO-16A-MaNGO OV2A phase 4 trial

Gennaro Daniele, Domenica Lorusso, Giovanni Scambia, Sabrina C. Cecere, Maria Ornella Nicoletto, Enrico Breda, Nicoletta Colombo, Grazia Artioli, Lucia Cannella, Giovanni Lo Re, Francesco Raspagliesi, Giuseppa Maltese, Vanda Salutari, Gabriella Ferrandina, Stefano Greggi, Alessandra Baldoni, Alice Bergamini, Maria Carmela Piccirillo, Germana Tognon, Irene FlorianiSimona Signoriello, Francesco Perrone, Sandro Pignata

Research output: Contribution to journalArticlepeer-review

Abstract

Background Few data are available on the outcome of surgery after a bevacizumab-containing regimen. The MITO 16A- MaNGO OV2A phase 4 trial evaluates the outcomes of first-line CPB in a clinical-practice-like setting. Here we present the results of the subgroup of patients undergoing IDS after neoadjuvant treatment or suboptimal primary surgery. Methods 400 chemonaïve epithelial ovarian cancer patients, age ≥ 18, ECOG PS 0–2 were eligible to receive C (AUC 5 d1, q21) plus P (175 mg/m2 d1, q21) and B (15 mg/kg d1 q21) for 6 cycles followed by B maintenance until cycle 22nd. Results 79 patients (20%) underwent IDS. Overall, 74 patients received at least one administration of B before IDS. Median age was 61.2, 70% of the patients had FIGO IIIC disease. The median number of cycles before IDS was 3 both for chemotherapy and bevacizumab respectively. A residual disease ≤ 1 cm was achieved in 64 patients (86.5%). Four percent of the patients experienced fever and 4% required blood transfusion after surgery. Surgical wound infection and/or dehiscence, pelvic abscess, intestinal sub-occlusion and fistula were experienced by one patient each. Conclusions In the MITO16A-MaNGO OV2A phase 4 trial, combined chemotherapy and bevacizumab did not hamper IDS and the rate of perioperative complications was similar to what expected without bevacizumab. These data support the hypothesis that adding bevacizumab to first line chemotherapy for ovarian cancer might not be denied to patients for whom IDS is planned.

Original languageEnglish
Pages (from-to)256-259
Number of pages4
JournalGynecologic Oncology
Volume144
Issue number2
Early online dateDec 16 2016
DOIs
Publication statusPublished - Feb 1 2017

Keywords

  • Bevacizumab
  • Interval debulking
  • Neoadjuvant
  • Ovarian cancer
  • Surgery

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynaecology

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