Bevacizumab–trabectedin combo holds promise in partially-platinum sensitive ovarian cancer

The combination of bevacizumab plus trabectedin (BT) shows promising clinical activity with limited toxicity in the treatment of women with partially platinum-sensitive ovarian cancer, according to the results of a phase II study. A regimen consisting of BT plus carboplatin also has good activity although with relatively increased toxicity.

A total of 67 women progressing between 6 and 12 months since their last platinum-based therapy were randomly assigned to the following treatment arms: BT every 21 days (n=20) or BT plus carboplatin (BT+C) every 28 days (n=47), from cycles 1 to 6.

Primary endpoints included progression-free survival rate (PFS) and severe toxicity rate (ST) at 6 months. Researchers assumed PFS ≤35 percent for the BT arm and ≤40 percent for the BT+C arm as not of therapeutic interest and an ST ≥30 percent for both arms as unacceptable.

In the BT arm, the PFS rate was 75 percent (95 percent confidence interval [CI], 60–87 percent; 50 patients) while the ST rate was 16 percent (95 percent CI, 7–30 percent).

On the other hand, BT+C did not meet the safety criteria for the second stage (ST rate, 45 percent, 95 percent CI, 23–69 percent). The PFS rate was 85 percent (95 percent CI, 62–97 percent).

The present data indicate that the BT regimen has potential for expanding the therapeutic armamentarium for women with partially platinum-sensitive ovarian cancer, the researchers said. Meanwhile, further studies of BT+C regimen, especially with a re-modulated schedule to limit its toxicity, are warranted.