Background: The addition of bevacizumab to standard chemotherapy prolongs progression free survival in the first\r\nline treatment of epithelial ovarian cancer (EOC), but its cost/effectiveness is debated. We assessed the safety and\r\nactivity of a lower dose of bevacizumab in pretreated advanced stage EOC.\r\nMethods: We treated 15 patients, mostly with platinum resistant EOC, who had received a median of four prior\r\ncytotoxic regimens, with bevacizumab 5ââ?¬â??7.5 mg/kg q21 days in combination with either carboplatin (n = 8), oral\r\ncyclofosfamide (n = 5) or weekly paclitaxel (n = 2). Bevacizumab was administered until disease progression. Tumor\r\nresponse was assessed by CA125 and fusion 18 F-FDG PET/contrast enhanced CT.\r\nResults: The median number of bevacizumab cycles was 21 (range 3ââ?¬â??59). The median baseline CA125 was 272 U/\r\nml and decreased to 15.2 U/ml at nadir. Tumor response was 4 complete response (CR) (26.7%) and 7 partial\r\nresponse (PR) (46.7%) by chemotherapy (CT), with an overall response rate of 73.4% (95% CI, 51.0 ââ?¬â?? 95.8) according\r\nto Response Evaluation Criteria In Solid Tumors (RECIST), and 6 CR (40%) and 4 PR (26.7%) by PET, for an overall\r\nmetabolic response rate of 67% (95%CI, 42.8 ââ?¬â?? 90.6) according to PET Response Criteria in Solid Tumors (PERCIST).\r\nMedian progression free survival (PFS) was 21 months and median overall survival (OS) was 24 months. Grade 3\r\nadverse events related to bevacizumab were hypertension (n = 2), proteinuria (n = 1) and epistaxis (n = 5). Treatment\r\nwas delayed in five patients for nasal bleeding or uncontrolled hypertension.\r\nConclusions: Low-dose bevacizumab and chemotherapy was well tolerated and active in a heavily pretreated\r\npopulation of advanced EOC. Further studies should assess the activity of low dose bevacizumab in EOC.
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