Mostafa Eyada, MD, University of Texas Medical Branch, Galveston, Texas, discusses a retrospective analysis aiming to assess the safety and efficacy of bevacizumab plus oral cyclophosphamide among patients with recurrent high-grade ovarian, fallopian tube, and primary peritoneal cancer.

This retrospective analysis found that bevacizumab in combination with oral cyclophosphamide was well tolerated and demonstrated antitumor activity, with a response rate of 40% among patients with recurrent platinum resistant high-grade ovarian cancer and a further 20% of patients achieving stable disease.

Transcript

Hello everyone, my name is Mostafa Eyada, I'm a third year OB/GYN resident from the University of Texas Medical Branch. I'll be talking about oral cyclophosphamide plus bevacizumab for patients with high-grade recurrent ovarian cancer. This study was done at MD Anderson Cancer Center.

So oral cyclophosphamide- bevacizumab and ipilimumab is the NCCN compendium listing, based on a phase 2 clinical trial, that lacked a comparison arm, so we wanted to test the efficacy and safety of oral cyclophosphamide and bevacizumab in patients with recurrent ovarian cancer, with a retrospective analysis study at MD Anderson. We enrolled platinum-sensitive or -resistant patients with ovarian cancer. We calculated the objective response rate as a patient who had partial or complete response, adverse events were collected and graded.

We enrolled 100 patients in our study and a majority were white, 75%, 83% had ovarian cancer, and a majority had high-grade serous ovarian cancer, 93%. 96% had stage IIIC or IV ovarian cancer. In terms of chemotherapy, a majority of patients were heavily treated prior to getting this regimen. They received a median of 3 prior lines of treatment and a majority were platinum-resistant, 86%.

In terms of response, 36% had partial response, 4% had complete response, 20% had stable disease and 40% had progressive disease. In terms of adverse events, 24% had adverse events Grades 3 or 4 toxicity, thrombocytopenia happened in 3%, nausea and vomiting 4% of patients, and hypertension in 3%, and hemorrhagic cystitis in less than 1%.

In terms of association with objective response rates, there was no relationship between number of prior lines of treatment and having a response to this regimen, and there was no relationship between platinum-status of the patient, or platinum-free interval and having a response to this regimen. Response rate for patients who were platinum-sensitive was 35% and for patients who were platinum-resistant was 39%. In terms of receiving bevacizumab in a prior treatment regimen, there was no relationship if the patient received bevacizumab in a prior treatment regimen to having a response to this regimen. The response rate for patients who did receive bevacizumab in a prior regimen was 36% and for those who had not receive bevacizumab was 42.

In conclusion, bevacizumab and oral cyclophosphamide was well-tolerated and effective for patients with recurrent ovarian cancer. We had an objective response rate of 40% and progression-free survival was 4.6 months.

Source:

Eyada M, Michael V, Fellman BM, et al. Oral cyclophosphamide plus bevacizumab in recurrent ovarian, fallopian tube and primary peritoneal cancer. Presented at the 2024 ASCO Annual Meeting. May 31-June 4, 2024; Chicago, IL. Abstract #5517.