Off-label use of bevacizumab for ovarian cancer almost doubled between 2008 and 2016 and is associated with a 6-fold increase in cost of one cycle of treatment compared with platinum- or taxane-based chemotherapy alone (JCO Oncol Pract. 2021 Apr 12;OP2000918. doi:10.1200/OP.20.00918).
This study aimed to quantify early dissemination patterns, factors influencing use, and costs of off-label bevacizumab for the treatment of newly diagnosed ovarian cancer in the United States.
The MarketScan database was used to identify 8109 women with newly diagnosed ovarian cancer treated with surgery and platinum-based chemotherapy from 2008 through 2016.
Researchers calculated the proportion of women receiving bevacizumab over time. Multivariate logistic regression was used to determine factors associated with bevacizumab use, and total costs per cycle of chemotherapy with and without bevacizumab.
During the study period, bevacizumab utilization increased 1.8-fold, from 4.1% in 2008 to 7.4% in 2016. Bevacizumab was used with non-platinum/taxane regimens 37.2% of the time. Factors associated with higher rates of use were physician specialty and geography. Clinical factors associated with bevacizumab use were metastatic disease and presence of ascites.
The median costs of one cycle of platinum/taxane chemotherapy plus bevacizumab was $10,897 compared with $1629 for platinum/taxane alone.
“Off-label use of BEV for newly diagnosed [ovarian cancer] was rare (<10%) but doubled following presentation of phase II and III data at international meetings,” wrote Soledad Jorge, MD, MPH, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Washington, Seattle, and colleagues.
Both clinical (ascites, metastatic disease, and age) and nonclinical (specialty and region) factors were associated with [bevacizumab] use, and its use was accompanied by a six-fold increase in the cost of one cycle of treatment,” they concluded.—Janelle Bradley
