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. 2024 Nov;35(6):e76.
doi: 10.3802/jgo.2024.35.e76. Epub 2024 Mar 26.

A retrospective study of dose-dense paclitaxel and carboplatin plus bevacizumab as first-line treatment of advanced epithelial ovarian cancer

Hiromi Komazaki  1 , Kazuaki Takahashi  1 , Hiroshi Tanabe  1   2 , Yuichi Shoburu  1 , Misato Kamii  1 , Akina Tsuda  1 , Motoaki Saito  1 , Kyosuke Yamada  1 , Hirokuni Takano  1 , Hirofumi Michimae  3 , Aikou Okamoto  1
Affiliations

A retrospective study of dose-dense paclitaxel and carboplatin plus bevacizumab as first-line treatment of advanced epithelial ovarian cancer

Hiromi Komazaki et al. J Gynecol Oncol. 2024 Nov.

Abstract

Objective: This study compared the effectiveness, safety, and tolerability of dose-dense paclitaxel and carboplatin plus bevacizumab (ddTC+Bev) with ddTC for advanced ovarian cancer.

Methods: We retrospectively analyzed the clinical records of 134 patients who received ddTC+Bev or ddTC as first-line chemotherapy for stage III-IV ovarian cancer. Progression-free survival as primary endpoint of this study was compared using the log-rank test. Cox proportional hazards model and propensity score matching (PSM) were used to analyze prognostic factors, and the frequency of adverse events was examined using the χ² test.

Results: We categorized 134 patients in the ddTC+Bev (n=57) and ddTC (n=77) groups who started treatment at four related institutions from November 2013 to December 2017. No patients used poly (ADP-ribose) polymerase inhibitors as the first line maintenance therapy. The progression-free survival (PFS) of the ddTC+Bev group had a significantly better prognosis than that of the ddTC group (hazard ratio [HR]=0.50; 95% confidence interval [CI]=0.32-0.79; p<0.003). Multivariate analysis showed that ddTC+Bev regimen was a prognostic factor. However, intergroup comparison using PSM revealed that the PFS of the ddTC+Bev group had a nonsignificantly better prognosis than that of the ddTC group (HR=0.70; 95% CI=0.41-1.20; p=0.189). Few adverse events above G3 were noted for ddTC+Bev, which were sufficiently tolerable.

Conclusion: This study could not demonstrate that adding Bev to ddTC improves prognosis. Further studies with more cases are warranted.

Keywords: Angiogenesis; Bevacizumab; Drug Therapy; Ovarian Neoplasms; Paclitaxel.

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Conflict of interest statement

Aikou Okamoto has honoraria from Takeda Pharmaceutical Company Ltd., AstraZeneca K.K., MSD K.K., Mochida Pharmaceutical Co., Ltd., Bayer Holding Ltd., Kaken Pharmaceutical Co., Ltd., ASKA Pharmaceutical Co., Ltd., Chugai Pharmaceutical Co., Ltd., Kissei Pharmaceutical Co., Ltd., Fuji Pharma Co., Ltd., Zeria Pharmaceutical Co., Ltd., Eisai Co., Ltd., and Takeda Pharmaceutical Company Ltd. Also, Dr. Okamoto was supported by research funding from Meiji Holdings Co., Ltd., Fuji Pharma Co., Ltd., Taiho Pharmaceutical Co., Ltd., Chugai Pharmaceutical Co., Ltd., Kaken Pharmaceutical Co., Ltd., Nippon Shinyaku Co., Ltd., ASKA Pharmaceutical Co., Ltd., Mochida Pharmaceutical Co., Ltd., MSD K.K., Eisai Co., Ltd., Takeda Pharmaceutical Company Ltd., Mochida Pharmaceutical Co., Ltd, Linical Co., Ltd., Pfizer Japan Inc., Gyne Mom Co.Ltd, Terumo Corporation, Kissei Pharmaceutical Co., Ltd., AstraZeneca K.K., Tsumura & Co., and Daiichi Sankyo Co., Ltd.

Figures

Fig. 1
Fig. 1. Flowchart of patient inclusion in the study.
Bev, bevacizumab; ddTC, dose-dense paclitaxel and carboplatin; FIGO, International Federation of Gynecology and Obstetrics.
Fig. 2
Fig. 2. PFS curves by product-limit method (pre-matching) according to chemotherapy regimen.
Bev, bevacizumab; ddTC, dose-dense paclitaxel and carboplatin; HR, hazard ratio; PFS, progression-free survival.
Fig. 3
Fig. 3. PFS curves by product-limit method (post-matching) according to chemotherapy regimen.
Bev, bevacizumab; ddTC, dose-dense paclitaxel and carboplatin; HR, hazard ratio; PFS, progression-free survival.
See this image and copyright information in PMC

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