Neo-adjuvant Versus Adjuvant Use of Bevacizumab in the Management of Advanced Ovarian Cancer العلاج ماقبل الجراحي و بعد الجراحي باستخدام بيفاسيزوماب في علاج حالات اورام المبيض المتقدمة

Document Type : Review Article

Authors

1 Clinical oncology department -faculty of medicine-Assiut university

2 women health hospital -faculty of medicine assiut university

3 clinical oncology departement - faculty of medicine- assiut university

4 clinical oncology department -faculty of medicine- assiut university

5 clinical oncology department , faculty of medicine Assiut university

Abstract

Ovarian cancer (OC) is the most lethal gynecologic malignancy . In 2018, Bevacizumab was approved by FDA for use with chemotherapy as treatment for women with advanced OC.

Objective: assessing the response, survival, and toxicity of Bevacizumab in patients who used it as Neoadjuvant or adjuvant with systemic therapy compared with cases who received only post-operative chemotherapy.

Design: an interventional prospective case-control study. included patients with AOCs presented to Assiut University hospitals from 2018 until 2021.



Intervention(s): group A: 15 patients underwent primary surgical resection then received adjuvant treatment , group B: 17 patients received NACT then underwent surgical resection followed by adjuvant therapy. and control group(C): 19 patients received only post-operative chemotherapy without Bevacizumab and were reviewed retrospectively.

Primary outcome: disease free survival (DFS), and overall survival (OS).

Secondary outcome: toxicity of Bevacizumab

Results: Comparisons between groups A and B revealed no significant differences regarding DFS, OS and toxicity. At one-year post-treatment there was a significantly lower CA-125 values in patients who used Bevacizumab (A&B) than conventional chemotherapy (group C). The 3 years OS was 25% for Groups (A&B) and only 5% for Group C.

Conclusions: bevacizumab improved response rate and overall survival without significant increase in side effects. Using it as adjuvant and as neo-adjuvant produced comparable success rates: taking in consideration that the neo-adjuvant use was applied to more advanced or irresectable cases: this means that bevacizumab could give this group an outcome similar to the primarily operable cases; larger studies are needed to confirm our findings.

Keywords

Bulletin of Pharmaceutical Sciences Assiut University

Articles in Press, Accepted Manuscript
Available Online from 20 December 2023

Files

Share

How to cite

Statistics